Individual
JOCELYN MAE LIVERMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
23 OCEAN AVE, PORTLAND, ME 04103-5740
(207) 272-7076
Mailing address
104 PENNELL AVE, PORTLAND, ME 04103-2030
(207) 272-7076
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC9112
ME
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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