Individual
MRS. HEAVEN FRANKIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
40 SUMMER ST, BANGOR, ME 04401-6446
(207) 947-0366
Mailing address
78 BICKFORD TER, ENFIELD, ME 04493-4460
(207) 732-5276
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL3614
ME
104100000X
Social Worker
—
ME
Other
Enumeration date
08/06/2007
Last updated
07/06/2010
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