MADELEINE PROVOST

SOUTH PORTLAND, ME
NPI1639061112
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: ME  SP4353)
Enumeration Date2025-07-17
Last Update Date2025-07-17
Business Address
MADELEINE PROVOST
117 SUMMIT TER APT 91
SOUTH PORTLAND, ME 04106-2276
Phone number: 413-386-5358
Mailing Address
MADELEINE PROVOST
117 SUMMIT TER APT 91
SOUTH PORTLAND, ME 04106-2276
Phone number: 413-386-5358
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