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Individual

MR. ALLEN ROBERT NORTHUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCC LPE

Contact information

Practice address
169 PARK ROW, BRUNSWICK, ME 04011
(207) 729-5426
(207) 725-2473
Mailing address
169 PARK ROW, BRUNSWICK, ME 04011-2039
(207) 729-5426
(207) 725-2473

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
272-LCPC
ME
104100000X
Social Worker
741-LPE
ME

Other

Enumeration date
08/24/2006
Last updated
07/08/2007
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