IndividualActive
Lacey Bourgoin, SLP-A
NPI 1528467792 · Speech-Language Assistant · Randolph, ME
Provider details
- NPI number
- 1528467792
- Entity type
- Individual
- Primary specialty
- Speech-Language AssistantSpeech, Language and Hearing Service Providers
- Credential
- SLP-A
- Sex
- Female
- Sole proprietor
- No
- License
- BH001153 (PA)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Behavioral Health & Social Service Providers
Practice location
17 School St
Randolph, ME 04346-5143
Phone: (207) 588-2699
Approximate (ZIP-level) locationGet directions
Mailing address
17 School St
Randolph, ME 04346-5143
Registry dates
- Enumerated
- 2014-08-14
- Last updated
- 2024-08-21
- Certified
- 2024-08-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.