Organization
SOTERIA MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE D HENNEBERRY PMHNP (VICE PRESIDENT)
(207) 907-4311
Entity
Organization
Contact information
Practice address
444 STILLWATER AVE, SUITE 210, BANGOR, ME 04401-3521
(207) 907-4311
(207) 907-4322
Mailing address
444 STILLWATER AVE, SUITE 210, BANGOR, ME 04401-3521
(207) 907-4311
(207) 907-4322
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
ME
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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