Individual
TRACY F BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 MT BLUE CIR, FARMINGTON, ME 04938-6276
(207) 860-3026
Mailing address
67 EUSTIS PKWY, WATERVILLE, ME 04901-5173
(207) 873-2136
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN73221
ME
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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