Individual
PHYLLIS MERRIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
247 COMMERCIAL ST, ROCKPORT, ME 04856-5964
(207) 470-7090
(207) 470-7094
Mailing address
72 MECHANIC ST, ROCKLAND, ME 04841-3514
(207) 594-0947
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC11515
ME
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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