Individual
NIKKI LEE GUDENSCHWAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 MOODY ST, SACO, ME 04072-1536
(207) 294-4414
Mailing address
4 BOODY ST, PORTLAND, ME 04102-2105
(207) 245-0133
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC4325
ME
101YM0800X
Mental Health Counselor
XL3834
ME
101YP2500X
Professional Counselor
1636-226
WI
Other
Enumeration date
01/12/2012
Last updated
04/20/2017
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