Individual
MRS. FAWN GILLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
268 STILLWATER AVE, BANGOR, ME 04401-3945
(207) 973-6100
Mailing address
268 STILLWATER AVE, BANGOR, ME 04401-3945
(207) 973-6100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL7606
ME
101YP2500X
Professional Counselor
XL7606
ME
Other
Enumeration date
05/07/2024
Last updated
09/13/2024
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