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NPI 1831330570

NPI 1831330570 : MARTHA PARO LANE : HIRAM, ME

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General NPI Number Information
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    NPI Number           |    1831330570
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    Entity Type          |    Individual 
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    Provider Name        |    MARTHA PARO LANE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/10/2009
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    Last Update Date     |    09/27/2013
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Provider Practice Location Address
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    Address Line         |    137 S HIRAM RD 
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    City                 |    HIRAM
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    State                |    ME
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    Zip                  |    04041-3636
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    Country              |    US
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    Telephone            |    207-934-0458
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    Fax                  |    207-872-6116
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Provider Business Mailing Address
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    Address Line         |    137 S HIRAM RD 
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    City                 |    HIRAM
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    State                |    ME
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    Zip                  |    04041-3636
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    Country              |    US
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    Telephone            |    207-934-0458
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    Fax                  |    207-872-6116
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2355S0801X
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    Taxonomy Name        |    Speech-Language Assistant
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    License Number       |    SAS1690
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    License Number State |    ME
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