Individual
DENISE LYAKHOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 COLLEGE CIR, BANGOR, ME 04401-2929
(207) 479-0708
Mailing address
28 BLANCHARD RD, MOUNT DESERT, ME 04660-6215
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
NONE
—
Enumeration date
06/20/2018
Last updated
06/20/2018
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