Individual
JENNA NUNZIATO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
Mailing address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC16239
ME
Other
Enumeration date
10/27/2014
Last updated
03/06/2020
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