Provider Demographics
NPI:1952649733
Name:ST.ONGE-BROWN, MAURA ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:ANN
Last Name:ST.ONGE-BROWN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BRIXHAM RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5331
Mailing Address - Country:US
Mailing Address - Phone:207-361-4359
Mailing Address - Fax:
Practice Address - Street 1:10 BRIXHAM RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-5331
Practice Address - Country:US
Practice Address - Phone:207-361-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP2209235Z00000X
NH0363235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist