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NPI Code Detail

MEDICARE: GAIL DENISE MAYBERRY

MEDICARE: GAIL DENISE MAYBERRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistST1724ME

General Provider Information

NPI Number : 1366614265
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAIL DENISE MAYBERRY
Provider Business Mailing Address
First Line : 105 MECHANIC ST
Second Line :
City : CAMDEN
State : ME
Zip : 04843-1811
Country : US
Telephone Number : 207-236-2573
Fax Number :
Provider Business Practice Location Address
First Line : 105 MECHANIC ST
Second Line :
City : CAMDEN
State : ME
Zip : 04843-1811
Country : US
Telephone Number : 207-236-2573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2008
Last Update Date : 03/31/2008

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Directions to “ GAIL DENISE MAYBERRY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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