Provider Demographics
NPI:1356684831
Name:PIKE, ELEANOR ROSE SCHWANER (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ROSE SCHWANER
Last Name:PIKE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ELEANOR
Other - Middle Name:ROSE
Other - Last Name:SCHWANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 BENSTONE RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:ME
Mailing Address - Zip Code:04238-3309
Mailing Address - Country:US
Mailing Address - Phone:207-446-5452
Mailing Address - Fax:
Practice Address - Street 1:38 BENSTONE RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:ME
Practice Address - Zip Code:04238-3309
Practice Address - Country:US
Practice Address - Phone:207-446-5452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07070235Z00000X
VA2202006730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist