Healthcare Provider Details

I. General information

NPI: 1356661151
Provider Name (Legal Business Name): KYLIE HESSERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 LONG PLAINS RD
BUXTON ME
04093-3208
US

IV. Provider business mailing address

35 WOODLAND RD
WINDHAM ME
04062-5607
US

V. Phone/Fax

Practice location:
  • Phone: 207-929-3836
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: