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Individual

LACEY M GUIOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
66 VINE ST, BANGOR, ME 04401-6029
(207) 941-6300
Mailing address
66 VINE ST, BANGOR, ME 04401-6029
(207) 941-6300

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TO2543
ME

Other

Enumeration date
09/26/2011
Last updated
05/25/2012
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