Individual
MRS. MARY BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
50 LYDIA LN, SOUTH PORTLAND, ME 04106-2156
(207) 874-1175
Mailing address
50 LYDIA LN, SOUTH PORTLAND, ME 04106-2156
(207) 874-1175
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL3731
ME
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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