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NPI 1548164320

NPI 1548164320 : MAINELY MEMORY FOUNDATION : DAMARISCOTTA, ME

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General NPI Number Information
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    NPI Number           |    1548164320
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    Entity Type          |    Organization 
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    Legal Business Name  |    MAINELY MEMORY FOUNDATION 
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Dates
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    Enumeration Date     |    10/06/2026
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    Last Update Date     |    10/06/2026
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Provider Practice Location Address
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    Address Line         |    157 MAIN ST 
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    City                 |    DAMARISCOTTA
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    State                |    ME
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    Zip                  |    04543-4649
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    Country              |    US
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    Telephone            |    207-240-4112
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    Fax                  |    207-512-1473
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Provider Business Mailing Address
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    Address Line         |    157 MAIN ST STE KB5 
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    City                 |    DAMARISCOTTA
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    State                |    ME
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    Zip                  |    04543-4649
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    Country              |    US
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    Telephone            |    207-240-4112
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    Fax                  |    207-512-1473
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Authorized Official
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    Title or Position    |    FOUNDER
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    Name                 |     JENNIFER H BRYCE 
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    Credential           |    SLP
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    Telephone            |    207-240-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    
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    License Number State |    NULL
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