Healthcare Provider Details

I. General information

NPI: 1003123142
Provider Name (Legal Business Name): HELENE SOKOL CASS M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 UPPER GUINEA RD
LEBANON ME
04027-4400
US

IV. Provider business mailing address

65 UPPER GUINEA RD P.O. BOX 159
LEBANON ME
04027-4400
US

V. Phone/Fax

Practice location:
  • Phone: 207-457-1299
  • Fax: 207-457-1829
Mailing address:
  • Phone: 207-457-1299
  • Fax: 207-457-1829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP497
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: