Healthcare Provider Details

I. General information

NPI: 1285073593
Provider Name (Legal Business Name): SWEET SONG SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 OLD DANVILLE RD
AUBURN ME
04210-8104
US

IV. Provider business mailing address

249 OLD DANVILLE RD
AUBURN ME
04210-8104
US

V. Phone/Fax

Practice location:
  • Phone: 207-240-7543
  • Fax:
Mailing address:
  • Phone: 207-240-7543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NAOMI S ST. HILAIRE
Title or Position: SOLE PROPRIETOR, OT
Credential: MSOTR/L
Phone: 207-240-7543