Individual
KEITA A. WHITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
470 FOREST AVE, PORTLAND, ME 04101-2009
(207) 874-1030
(207) 899-4623
Mailing address
470 FOREST AVE, PORTLAND, ME 04101-2009
(207) 854-1030
(207) 899-4623
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC12864
ME
Other
Enumeration date
04/26/2011
Last updated
07/11/2013
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