Individual
KATELYN JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
48 BEECH ST, LISBON, ME 04250-6476
(207) 240-8656
Mailing address
48 BEECH ST, LISBON, ME 04250-6476
(207) 240-8656
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2670
ME
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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