Provider Demographics
NPI:1386858090
Name:TOPPER, DOUGLAS R
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
Last Name:TOPPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:MASON TWP
Mailing Address - State:ME
Mailing Address - Zip Code:04217-7221
Mailing Address - Country:US
Mailing Address - Phone:207-836-2840
Mailing Address - Fax:
Practice Address - Street 1:243 KINGS HWY
Practice Address - Street 2:
Practice Address - City:MASON TWP
Practice Address - State:ME
Practice Address - Zip Code:04217-7221
Practice Address - Country:US
Practice Address - Phone:207-836-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST1624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist