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Individual

SHERYL A BROCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC C

Contact information

Practice address
33 PENN PLZ STE C, BANGOR, ME 04401-3619
(207) 949-0717
Mailing address
3 PROUTY DRIVE, VEAZIE, ME 04401
(207) 942-3907

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL2972
ME

Other

Enumeration date
01/17/2007
Last updated
09/23/2010
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