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General NPI Number Information
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NPI Number | 1356740997
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Entity Type | Organization
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Legal Business Name | SOUTHERN MAINE HEARING, INC
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 251 US ROUTE 1 STE 9
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City | FALMOUTH
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State | ME
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Zip | 04105-1322
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Country | US
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Telephone | 207-781-7200
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Fax | 207-781-7203
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Provider Business Mailing Address
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Address Line | 251 US ROUTE 1 STE 9
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City | FALMOUTH
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State | ME
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Zip | 04105-1322
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Country | US
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Telephone | 207-781-7200
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Fax | 207-781-7203
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH HOLLY THIBODEAU
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Credential | ED.D.
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Telephone | 207-233-1167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AP2234
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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