Organization
STOREYSMITH PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME STOREYSMITH OT (DIRECTOR)
(207) 829-8007
Entity
Organization
Contact information
Practice address
85 MIDDLE RD, CUMBERLAND, ME 04021-3707
(207) 829-8007
(207) 829-8008
Mailing address
85 MIDDLE RD, CUMBERLAND, ME 04021-3707
(207) 829-8007
(207) 829-8008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP667
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23494099
—
ME
Enumeration date
04/23/2007
Last updated
08/22/2020
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