Individual
MICHAEL LAWRENCE GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC-CONDITIONAL
Contact information
Practice address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
(207) 626-3612
Mailing address
66 STONE ST, AUGUSTA, ME 04330-5227
(207) 626-3455
(207) 626-3612
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC3046
ME
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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