Organization
AND BREATHE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNYN VICENTE (OWNER)
(207) 274-9639
Entity
Organization
Contact information
Practice address
47 PORTLAND ST, 2ND FL., PORTLAND, ME 04101-3188
(207) 274-9639
Mailing address
95 PARKER ST, NEWBURYPORT, MA 01950-4033
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962761361
—
ME
Enumeration date
05/07/2012
Last updated
04/02/2013
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