Christine Petrillo

Individual provider Active NPI Speech-Language Pathologist · North Berwick, ME

NPI 1376858670 · NPPES record last updated Aug 11, 2010

Key facts

NPI
1376858670
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP1213 (ME)
Practice address
25 Varney Rd
North Berwick, ME 03906-6142
Phone
(207) 676-9811
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
No

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
SP1213MEMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1213 ME Yes

Addresses

Primary practice location

25 Varney Rd
North Berwick, ME 03906-6142

Mailing address

222 Rollingwood Rd
Eliot, ME 03903-1525

Other providers in North Berwick, ME

All providers in North Berwick, ME · Speech-Language Pathologist in Maine

Sources for this page

Verify at the official NPI Registry.