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Organization

PANDORA TALKS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARCY WALLACE LIBBY CCC-SLP (SPEECH/LANGUAGE PATHOLOGIST)
(207) 443-8912
Entity
Organization

Contact information

Practice address
18 MILLER ST, WOOLWICH, ME 04579-4573
(207) 443-8912
(207) 443-8749
Mailing address
18 MILLER ST, WOOLWICH, ME 04579-4573
(207) 443-8912
(207) 443-8749

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT777
ME
235Z00000X
Speech-Language Pathologist
Primary
SP1153
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
261820099
ME
Enumeration date
11/17/2010
Last updated
11/17/2010
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