Individual
KELLY WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
143 POTTLE RD, OXFORD, ME 04270-3362
(207) 743-7911
Mailing address
1155 LISBON ST, LEWISTON, ME 04240-5025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC13251
ME
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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