Individual
KAY I LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
99 WESTERN AVE, SUITE # 12, AUGUSTA, ME 04330-7229
(207) 622-0026
(207) 622-0002
Mailing address
99 WESTERN AVE, SUITE #12, AUGUSTA, ME 04330-7229
(207) 622-0026
(207) 622-0026
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1136
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121210000
—
ME
Enumeration date
08/28/2008
Last updated
04/30/2009
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