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Individual

MRS. MARCIA GAIL ROSENTHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC SLP

Contact information

Practice address
10 SUNNY BANK ROAD, CAPE ELIZABETH, ME 04107
(207) 767-2393
Mailing address
10 SUNNY BANK ROAD, CAPE ELIZABETH, ME 04107
(207) 767-2393

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1298 W
MA
235Z00000X
Speech-Language Pathologist
Primary
SP1561
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11457327
CAQH
01
SP0114
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/19/2007
Last updated
07/09/2007
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