Individual
KIM WALLANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, RPT, ATR
Contact information
Practice address
865 WOODMANS MILL RD, MONTVILLE, ME 04941-4637
(561) 351-4256
Mailing address
865 WOODMANS MILL RD, MONTVILLE, ME 04941-4637
(561) 351-4256
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC6610
ME
Other
Enumeration date
09/26/2014
Last updated
10/17/2024
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