Individual
BROOKE PROULX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
98 RUSSELL ST, LEWISTON, ME 04240-6004
(207) 784-7144
Mailing address
19 CURTIS ST, SOUTH PORTLAND, ME 04106-3513
(207) 332-3060
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC12139
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434387099
—
ME
Enumeration date
08/03/2009
Last updated
08/03/2009
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