Individual
JESSICA GUERETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1211
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC14905
ME
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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