| NPI | 1043597503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE OUELLETTE Director 207-989-9008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME AP081148) |
| Enumeration Date | 2011-11-12 |
| Last Update Date | 2011-11-12 |