Individual
LAURA MAZIKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
22 FREE ST STE 402, PORTLAND, ME 04101-3900
(207) 772-0050
Mailing address
22 FREE ST STE 402, PORTLAND, ME 04101-3900
(207) 772-0050
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL2945
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432107699
—
ME
Enumeration date
11/21/2006
Last updated
08/06/2009
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