Individual
LORI AXELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-3978
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11101
ME
Other
Enumeration date
12/26/2013
Last updated
12/26/2013
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