Individual
DESTRY OLDHAM-SIBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
(207) 626-7586
Mailing address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
(207) 626-7586
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
CC2710
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP131060
ME
Other
Enumeration date
04/02/2007
Last updated
03/21/2014
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