Individual
SHARON PEABODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MESSALONSKEE AVE, WATERVILLE, ME 04901-5206
(207) 873-4281
Mailing address
88 TARYBELU LN, CHINA, ME 04358-4003
(207) 968-3809
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP548
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
611592446
—
ME
Enumeration date
09/03/2010
Last updated
09/03/2010
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