Individual
JILLIAN KIMBERLY EASTTEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
75 JOHN ROBERTS RD STE B8, SOUTH PORTLAND, ME 04106-6964
(207) 775-4151
Mailing address
75 JOHN ROBERTS RD STE B8, SOUTH PORTLAND, ME 04106-6964
(207) 775-4151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC24011
ME
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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