Provider Demographics
NPI:1982126074
Name:MAXIM, HILARY ANNE (AUD)
Entity Type:Individual
Prefix:MISS
First Name:HILARY
Middle Name:ANNE
Last Name:MAXIM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 STRAWBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5952
Mailing Address - Country:US
Mailing Address - Phone:207-786-3305
Mailing Address - Fax:207-517-6163
Practice Address - Street 1:195 FORE RIVER PKWY STE 210
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2783
Practice Address - Country:US
Practice Address - Phone:207-535-1150
Practice Address - Fax:207-775-3378
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP2682231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist