Provider Demographics
NPI:1043264468
Name:GILBERT, MARCIA MERCEILLE (MS, CCC/A)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:MERCEILLE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MS, CCC/A
Other - Prefix:MRS
Other - First Name:MARCIA
Other - Middle Name:MERCEILLE
Other - Last Name:HAMMETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:312 WING RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HERMON
Mailing Address - State:ME
Mailing Address - Zip Code:04401-0424
Mailing Address - Country:US
Mailing Address - Phone:207-848-7007
Mailing Address - Fax:207-848-7007
Practice Address - Street 1:312 WING RD
Practice Address - Street 2:SUITE B
Practice Address - City:HERMON
Practice Address - State:ME
Practice Address - Zip Code:04401-0424
Practice Address - Country:US
Practice Address - Phone:207-848-7007
Practice Address - Fax:207-848-7007
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP 1091231H00000X
MEAP1091231HA2400X, 231HA2500X
MEDL20000375237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Not Answered237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME061498OtherANTHEM
ME3909913OtherAETNA