| NPI | 1699226167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE MACDONALD Owner 207-205-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC8956) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA Sw110393-01) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |