Healthcare Provider Details

I. General information

NPI: 1326251232
Provider Name (Legal Business Name): DANIKA JAE KUHL MS-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 MAIN ST SUITE 202
SOUTH PORTLAND ME
04106-5448
US

IV. Provider business mailing address

42 GOUDY ST
S PORTLAND ME
04106-4940
US

V. Phone/Fax

Practice location:
  • Phone: 207-831-1049
  • Fax: 207-829-8248
Mailing address:
  • Phone: 207-831-1049
  • Fax: 207-808-8952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP533
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: