Individual
MRS. MARILYN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
577 MOUNT VIEW RD, THORNDIKE, ME 04986-3307
(207) 568-4609
Mailing address
67 JOHNSON HTS, WATERVILLE, ME 04901-4908
(207) 873-5422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1499
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP1499
MAINECARE
ME
Enumeration date
09/01/2010
Last updated
09/01/2010
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