| NPI | 1104097948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN M. R. JACKSON Owner 207-780-9966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC1392 ME) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-20 |