Individual
ALEXIS PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
42 CEDAR ST, BANGOR, ME 04401-6433
(207) 922-4600
(207) 564-3975
Mailing address
42 CEDAR ST, BANGOR, ME 04401-6433
(207) 922-4600
(207) 564-3975
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC18211
ME
Other
Enumeration date
10/18/2019
Last updated
11/11/2021
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