| NPI | 1063962116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN M BASTEK Billing Specialist 207-351-3078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: ME SP2587) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |