Individual
SHANELLE RAVESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 BLUEBERRY RD, PORTLAND, ME 04102-1924
(207) 747-5226
Mailing address
1087 FOREST AVE, PORTLAND, ME 04103-3321
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC21188
ME
Other
Enumeration date
08/09/2022
Last updated
09/30/2024
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