Provider Demographics
NPI:1205238813
Name:WHITE, MARIE-ANNE
Entity type:Individual
Prefix:
First Name:MARIE-ANNE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PLUMMER MILL RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04222-5312
Mailing Address - Country:US
Mailing Address - Phone:207-577-1704
Mailing Address - Fax:
Practice Address - Street 1:3 OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ME
Practice Address - Zip Code:04250-6214
Practice Address - Country:US
Practice Address - Phone:207-318-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS15882355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant