Individual
NICOLE PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 MIECASKLY DR, NEW GLOUCESTER, ME 04260-4670
(207) 774-3570
Mailing address
24 MIECASKLY DR, NEW GLOUCESTER, ME 04260-4670
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC17380
ME
Other
Enumeration date
08/10/2016
Last updated
10/09/2024
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