Individual
BRANDON L OUELLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC-C
Contact information
Practice address
71 US ROUTE 1 STE G, SCARBOROUGH, ME 04074-7174
(207) 774-3570
Mailing address
9 CARRIER WOOD RD APT 70, SCARBOROUGH, ME 04074-7190
(207) 551-7715
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
XL5091
ME
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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