Lisette Michelle Trevino | Portland, ME • PECOS Search

Lisette Michelle Trevino

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

22 Bramhall St, Portland, ME 04102-3134

(207) 662-4892 (207) 662-0111

PECOS Enrollment

Based on the most recent information from CMS, provider Lisette Michelle Trevino does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1073355012
Provider Type
Individual
Full Name
Trevino, Lisette Michelle
Credential
SLP

Gender
Female
Sole Proprietor
No
Enumeration Date
6/11/2024
Last Updated
3/31/2025

Contact Information

Practice Location

22 Bramhall St, Portland, ME 04102-3134

Unlisted Fax

Mailing Location

22 Bramhall St, Portland, ME 04102-3134

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License SP4334 Maine