Provider Demographics
NPI:1104692953
Name:DOIRON, COLLEEN (LMT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:DOIRON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HESELTON ST
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-2512
Mailing Address - Country:US
Mailing Address - Phone:610-505-1756
Mailing Address - Fax:
Practice Address - Street 1:3 SAINT CATHERINE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5732
Practice Address - Country:US
Practice Address - Phone:610-505-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2024-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT5927225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist