Individual
MS. LAURA SPECYAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SP
Contact information
Practice address
36 GRANDVIEW ACRES, GLENBURN, ME 04401
(207) 884-8110
Mailing address
36 GRANDVIEW ACRES, GLENBURN, ME 04401
(207) 884-8110
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP567
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024324
ANTHEM BCBS NUMBER
ME
Enumeration date
05/07/2007
Last updated
07/09/2007
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