Individual
MS. GABRIELLE BROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
30 PITT STREET, PORTLAND, ME 04103-4886
(207) 828-1023
Mailing address
30 PITT STREET, PORTLAND, ME 04103-4886
(207) 828-1025
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
CC1068
ME
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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