JENNIFER FORMICOLA

PORTLAND, ME
NPI1174163026
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2020-01-08
Last Update Date2020-01-08
Business Address
JENNIFER FORMICOLA LCSW
160 PREBLE ST
PORTLAND, ME 04101-2426
Phone number: 207-420-0601
Mailing Address
JENNIFER FORMICOLA LCSW
160 PREBLE ST
PORTLAND, ME 04101-2426
Phone number: 207-420-0601
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