Healthcare Provider Details

I. General information

NPI: 1033035944
Provider Name (Legal Business Name): CHICKADEE AUDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 OLIVE STREET
BANGOR ME
04401
US

IV. Provider business mailing address

735 MAIN ST
BANGOR ME
04401-6809
US

V. Phone/Fax

Practice location:
  • Phone: 570-472-2600
  • Fax:
Mailing address:
  • Phone: 570-472-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: JAIME LYNN BARRALL
Title or Position: OWNER, AUDIOLOGIST
Credential: AU. D.
Phone: 570-472-2600