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Individual

ROBIN M KONIECZKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA,CCC,SLP

Contact information

Practice address
55 WESTON AVE, MADISON, ME 04950-1227
(207) 696-3323
(207) 696-5631
Mailing address
55 WESTON AVE, MADISON, ME 04950-1227
(207) 696-3323
(207) 696-5631

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1058
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
999808537
ME
Enumeration date
08/17/2010
Last updated
08/17/2010
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