Provider Demographics
NPI:1578709432
Name:PUHLMAN, JANE ELLEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ELLEN
Last Name:PUHLMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 DUNN HALL
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04469-0001
Mailing Address - Country:US
Mailing Address - Phone:207-581-2008
Mailing Address - Fax:
Practice Address - Street 1:92 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1776
Practice Address - Country:US
Practice Address - Phone:207-404-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-25
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP3007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist