Individual
DESIREE PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 GRAHAM AVE N, BANGOR, ME 04401-5815
(207) 808-2205
Mailing address
10 GRAHAM AVE N, BANGOR, ME 04401-5815
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2939
ME
235Z00000X
Speech-Language Pathologist
ST2814
ME
Other
Enumeration date
06/04/2018
Last updated
04/19/2022
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