Individual
JENNIFER L PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
9 HILLCREST AVE, RANDOLPH, ME 04346-5131
(207) 582-9206
(207) 582-9652
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC4825
ME
171W00000X
Contractor
LS6727
ME
Other
Enumeration date
04/12/2007
Last updated
05/16/2019
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