Individual
SUSANNAH ELIZABETH MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
175 UNION ST, BANGOR, ME 04401-6100
(207) 941-2850
(208) 941-2852
Mailing address
175 UNION ST, BANGOR, ME 04401-6100
(207) 941-2850
(208) 941-2852
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1776
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432335699
—
ME
Enumeration date
11/17/2006
Last updated
11/23/2007
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