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Individual

DEBRA J DONELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
222 SAINT JOHN ST, SUITE 256, PORTLAND, ME 04102-3041
(207) 671-6444
Mailing address
42 CLIFF AVE, CAPE ELIZABETH, ME 04107-5011
(207) 650-2168

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC4681
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
328790099
ME
Enumeration date
10/03/2006
Last updated
05/03/2011
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