Individual
GEORGANA PRUDHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
66 PEARL ST, PORTLAND, ME 04101-4165
(207) 773-9931
Mailing address
10 BAYWOOD LN, YARMOUTH, ME 04096-6131
(207) 847-3086
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC8342
ME
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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