Individual
ELENA USOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 PORTLAND AVE APT 7, OLD ORCHARD BEACH, ME 04064-1527
(207) 286-6625
Mailing address
71 ROUTE 1, SCARBOROUGH, ME 04070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL4100
ME
Other
Enumeration date
02/15/2013
Last updated
02/20/2013
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