| Doctor Name: | ELLEN H DECOTIIS |
| NPI Number: | 1578572079 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.L.P |
| License Number: | SP439 |
| Business Practice Address: | 510 Main St Stop C Gorham, ME - 040381339 |
| Business Phone Number: | 2078394007 |
| Business Fax Number: | |
| Mailing Address: | Po Box 608, BAR MILLS |
| State: | ME |
| Postal Code: | 040040608 |
| Phone Number: | 2079294104 |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 11/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP439 |
| 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 |