Provider Demographics
NPI:1548794423
Name:THE MAINE CHATTERBOX, LLC
Entity Type:Organization
Organization Name:THE MAINE CHATTERBOX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HARRIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:207-356-9537
Mailing Address - Street 1:20 MECHANIC ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1560
Mailing Address - Country:US
Mailing Address - Phone:207-356-9537
Mailing Address - Fax:888-373-3494
Practice Address - Street 1:20 MECHANIC ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1560
Practice Address - Country:US
Practice Address - Phone:207-356-9537
Practice Address - Fax:888-373-3494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1826252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency