Diane Smith
Individual provider Active NPI Developmental Therapist · Farmingdale, ME
NPI 1578893905 · NPPES record last updated Jan 7, 2010
Key facts
- NPI
- 1578893905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- License
- 403825 (ME)
- Practice address
- 15 Beech St
Farmingdale, ME 04344-1603 - Phone
- (207) 622-2976
- NPI assigned
- Jan 7, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 403825 | ME | MD | Developmental Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 403825 | ME | Yes |
Addresses
Primary practice location
15 Beech St
Farmingdale, ME 04344-1603
Mailing address
15 Beech St
Farmingdale, ME 04344-1603
Phone (207) 622-2976
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135210000 | Medicaid | ME |
Other providers in Farmingdale, ME
- Elaine C Quinn
- Cheyenne Gogolinski Ross
- Nicole C Shipp
- Jessica M Sikora
- Smart Vision, LLC
- Southern Kennebec Child Development Corp.
- Sigrid Stephens
- Stepping Stones Therapy Services
- Michele G Stevens
- Elisha Steward
All providers in Farmingdale, ME · Developmental Therapist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.