Individual
JUDITH LEIGH PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
204 KANSAS RD, NAPLES, ME 04055-3007
(207) 693-5194
Mailing address
204 KANSAS RD, NAPLES, ME 04055-3007
(207) 693-5194
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11508
ME
1041S0200X
School Social Worker
LC11508
ME
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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