Individual
MRS. DANA ELIZABETH MANEL JARVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
22 FREE ST STE 402, PORTLAND, ME 04101-3900
(207) 900-3002
Mailing address
22 FREE ST STE 402, PORTLAND, ME 04101-3900
(207) 900-3002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8525
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412190099
MAINECARE PROVIDER NUMBER
ME
01
—
LC8525
SOCIAL WORK LICENSE #
ME
Enumeration date
08/23/2006
Last updated
11/25/2024
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