Individual
MRS. EMILY LUSENHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 STATE ST, PORTLAND, ME 04101-3751
(207) 871-7431
Mailing address
66 STATE ST, PO BOX 797, PORTLAND, ME 04101-3751
(207) 871-7431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC15322
ME
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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