Individual
KATHLEEN J MONGILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,ARNP,BC
Contact information
Practice address
200 LANCASTER STREET, PORTLAND, ME 04101-2418
(207) 772-2133
Mailing address
944 S HIGH ST, BRIDGTON, ME 04009-3919
(603) 447-6339
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R038450
ME
Other
Enumeration date
05/26/2006
Last updated
07/08/2007
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