Individual
SUZANNE CORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35 N COUNTY RD, HAMPDEN, ME 04444-3401
(207) 862-3528
Mailing address
35 N COUNTY RD, HAMPDEN, ME 04444-3401
(207) 862-3528
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223780000
—
ME
Enumeration date
12/10/2009
Last updated
12/10/2009
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