| Heartleaf Aba LLC | |
|
396 Griffin Rd Unit 106 Bangor ME 04401-3023 | |
| (207) 745-0750 | |
| Not Available |
| Full Name | Heartleaf Aba LLC |
|---|---|
| Speciality | Behavior Analyst |
| Location | 396 Griffin Rd Unit 106, Bangor, Maine |
| Authorized Official Name and Position | Judy Seals (NETWORK OPERATIONS DIRECTOR) |
| Authorized Official Contact | 2075731000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartleaf Aba LLC 396 Griffin Rd Unit 106 Bangor ME 04401-3023 Ph: (207) 745-0750 | Heartleaf Aba LLC 396 Griffin Rd Unit 106 Bangor ME 04401-3023 Ph: (207) 745-0750 |
| NPI Number | 1063141174 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063141174 | NPI | - | NPPES |
| 39604401 | Other | ME | ADDRESS AND ZIP CODE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | () | Primary |
| 225XM0800X | Occupational Therapist - Mental Health | () | Secondary |
| 235Z00000X | Speech-language Pathologist | () | Secondary |
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