Melissa Metivier

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

NPI 1922313337 · NPPES record last updated Apr 23, 2018

Key facts

NPI
1922313337
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP1971 (ME)
Practice address
73 Harlow St
Bangor, ME 04401-5118
Phone
(207) 992-4156
NPI assigned
Aug 10, 2010
Sex
Female
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
SP1971MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Bangor Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1971 ME Yes

Addresses

Primary practice location

73 Harlow St
Bangor, ME 04401-5118

Mailing address

73 Harlow St
Bangor, ME 04401-5118
Phone (207) 992-4156

Other providers in Bangor, ME

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

Sources for this page

Verify at the official NPI Registry.