Individual
DR. ELIZABETH ANNE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPD
Contact information
Practice address
985 FOREST AVE, PORTLAND, ME 04103-3303
(207) 797-2351
(207) 797-8650
Mailing address
985 FOREST AVE, PORTLAND, ME 04103-3303
(207) 797-2351
(207) 797-8650
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP886
ME
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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