Individual
MRS. ANNE M BOURQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 LEDGE HILL WAY, WEST GARDINER, ME 04345-3135
(207) 582-3146
Mailing address
22 LEDGE HILL WAY, WEST GARDINER, ME 04345-3135
(207) 582-3146
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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