Robby Joel Desjardins, SPEECH PATHOLOGIST

Individual provider Active NPI Speech-Language Pathologist · Madawaska, ME

NPI 1295948859 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1295948859
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
94 (ME)
Practice address
88 Fox St
Suite 101
Madawaska, ME 04756-1352
Phone
(207) 728-6341
Fax
(207) 728-7762
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
94MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aroostook Mental Health Services, Inc. Past
since Sep 30, 2012
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 94 ME Yes

Addresses

Primary practice location

88 Fox St
Suite 101
Madawaska, ME 04756-1352

Mailing address

88 Fox St
Suite 101
Madawaska, ME 04756-1352
Phone (207) 728-6341

Other providers in Madawaska, ME

All providers in Madawaska, ME · Speech-Language Pathologist in Maine

Sources for this page

Verify at the official NPI Registry.