Individual
LIZA ANNE HASKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
190 BANGOR RD, ELLSWORTH, ME 04605-3258
(207) 667-7108
Mailing address
190 BANGOR RD, ELLSWORTH, ME 04605-3258
(207) 667-7108
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
400880
ME
Other
Enumeration date
08/18/2008
Last updated
08/18/2008
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