| NPI | 1265972749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL R MELVIN Member 207-773-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC4787) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |