Organization
CHRISTOPHER GLENN CHIVERTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER CHIVERTON (OWNER)
(585) 613-2657
Entity
Organization
Contact information
Practice address
386 FORE ST STE 304, PORTLAND, ME 04101-7406
(585) 613-2657
Mailing address
271 BRACKETT ST APT 1, PORTLAND, ME 04102-3219
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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