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1144360108
RISA MOON
PORTLAND, ME
NPI
1144360108
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ME lc9746)
Enumeration Date
2007-02-07
Last Update Date
2007-07-08
Business Address
-- RISA MOON LCSW
609 FOREST AVE 2ND FLOOR
PORTLAND, ME 04101-1515
Phone number: 207-712-4031
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Mailing Address
-- RISA MOON LCSW
609 FOREST AVE 2ND FLOOR
PORTLAND, ME 04101-1515
Phone number: 207-712-4031
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