Organization
NANCY MAIELLO LICSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY MAIELLO LICSW (OWNER)
(207) 752-0731
Entity
Organization
Contact information
Practice address
90 WHITNEY AVE, PORTLAND, ME 04102-2586
(207) 752-0731
Mailing address
90 WHITNEY AVE, PORTLAND, ME 04102-2586
(207) 752-0731
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
653
NH
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/12/2012
Last updated
10/04/2021
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