Individual
AMY NUSSINOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
918 SABATTUS STREET, LEWISTON, ME 04240
(207) 782-1680
(207) 782-2534
Mailing address
72 STRAWBERRY AVE, LEWISTON, ME 04240-5952
(207) 782-2150
(207) 782-3621
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP535
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297810099
—
ME
Enumeration date
12/12/2006
Last updated
01/26/2017
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