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1215988852
MICHELLE D HENNEBERRY
BANGOR, ME
NPI
1215988852
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
(Licence: ME R037051)
Enumeration Date
2006-05-16
Last Update Date
2009-12-17
Business Address
MICHELLE D HENNEBERRY PMHNP
263 STATE ST SUITE 23
BANGOR, ME 04401-5435
Phone number: 207-945-3615
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Mailing Address
MICHELLE D HENNEBERRY PMHNP
263 STATE ST SUITE 23
BANGOR, ME 04401-5435
Phone number: 207-945-3615
Copy
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