| Doctor Name: | MS. MARY STURTEVANT |
| NPI Number: | 1053620294 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SL |
| License Number: | 293 020 |
| Business Practice Address: | 23 Highland Ave Winthrop, ME - 043641506 |
| Business Phone Number: | 2073772241 |
| Business Fax Number: | 2073778658 |
| Mailing Address: | 23 Highland Ave, WINTHROP |
| State: | ME |
| Postal Code: | 043641506 |
| Phone Number: | 2073772241 |
| Fax Number: | 2073778658 |
| NPI Enumeration Date: | 10/06/2010 |
| NPI Last Update Date: | 10/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | 293 020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |