Individual ProviderTessa RubioSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address1145 Brighton Ave, Portland, ME 04102-1025(207) 541-6500(570) 902-5375PECOS EnrollmentBased on the most recent information from CMS, provider Tessa Rubio 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 4 days ago.Profile DetailsProvider ID1619588696Provider TypeIndividualFull NameRubio, TessaGenderFemaleSole ProprietorYesEnumeration Date8/12/2020Last Updated12/16/2024Contact InformationPractice LocationPractice Address1145 Brighton Ave, Portland, ME 04102-1025Phone(207) 541-6500FaxUnlisted FaxMailing LocationMailing Address615 Heath St, Chestnut Hill, MA 02467-2160Phone(570) 902-5375FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicenseSP3390MaineCode235Z00000XDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense605939MassachusettsProvider IdentifiersIDDescriptionIssuerIDSP3390DescriptionOtherIssuerSTATE OF MAINEMaine