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Individual

COLLEEN M NILAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. CCC-SLP

Contact information

Practice address
797 WILSON ST STE 2, BREWER, ME 04412-1003
(207) 947-8493
(207) 990-4819
Mailing address
317 FERN ST, BANGOR, ME 04401-4041
(207) 212-3296
(207) 990-4819

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP898
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
024708
ANTHEM
ME
05
235550099
ME
Enumeration date
11/15/2006
Last updated
09/18/2023
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