Individual ProviderLisette TrevinoSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address22 Bramhall St, Portland, ME 04102-3134(207) 662-4892(479) 719-6824PECOS EnrollmentBased on the most recent information from CMS, provider Lisette Trevino does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1073355012Provider TypeIndividualFull NameTrevino, LisetteGenderFemaleSole ProprietorNoEnumeration Date6/11/2024Last Updated6/11/2024Contact InformationPractice LocationPractice Address22 Bramhall St, Portland, ME 04102-3134Phone(207) 662-4892FaxUnlisted FaxMailing LocationMailing Address21 Camden St Unit 2118, Scarborough, ME 04074-7593Phone(479) 719-6824FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseST4105Maine