Individual
JESSICA DEMERISE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
202 EXCHANGE ST, BANGOR, ME 04401-6508
(207) 941-6434
(207) 941-9366
Mailing address
202 EXCHANGE ST, BANGOR, ME 04401-6508
(207) 941-6434
(207) 941-9366
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL4254
ME
Other
Enumeration date
12/09/2013
Last updated
06/18/2024
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