Individual
MS. LEESE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 COOL ST, WATERVILLE, ME 04901-5221
(207) 873-0721
Mailing address
142 WESTERN AVE APT 1, WATERVILLE, ME 04901-5215
(207) 487-1496
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
08905
MD
235Z00000X
Speech-Language Pathologist
13853
NC
235Z00000X
Speech-Language Pathologist
Primary
2202009174
VA
235Z00000X
Speech-Language Pathologist
SP1962
ME
Other
Enumeration date
02/21/2008
Last updated
07/22/2020
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