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1104151968
TIFFANY BEAN
SOUTH PORTLAND, ME
NPI
1104151968
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: ME LC3492)
Enumeration Date
2009-10-13
Last Update Date
2009-10-13
Business Address
-- TIFFANY BEAN LADC
525 MAIN ST
SOUTH PORTLAND, ME 04106-5462
Phone number: 207-874-1045
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Mailing Address
-- TIFFANY BEAN LADC
525 MAIN ST
SOUTH PORTLAND, ME 04106-5462
Phone number: 207-874-1045
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