Organization Name: | FAGAN CENTER FOR COMMUNICATON LLC |
NPI Number: | 1174757991 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN MCKINLEY (BILLING MANAGER) |
Mailing Address: | 985 Forest Ave Portland |
State: | ME US |
Postal Code: | 041033303 |
Phone Number: | 2077972351 |
Fax Number: | 2078392197 |
NPI Enumeration Date: | 05/07/2009 |
NPI Last Update Date: | 05/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP886 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |