Organization
MINDFUL LOTUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA EVANS POWELL LCSW (SOCIAL WORKER)
(207) 650-0625
Entity
Organization
Contact information
Practice address
49 CUMMINGS AVE, BUXTON, ME 04093-3336
(207) 650-0625
Mailing address
49 CUMMINGS AVE, BUXTON, ME 04093-3336
(207) 650-0625
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376736579
—
ME
Enumeration date
12/07/2018
Last updated
12/07/2018
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