Individual
HENRIETTA S POONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
650 EVERGREEN WOODS, BANGOR, ME 04401
(207) 942-1565
(207) 942-7430
Mailing address
650 EVERGREEN WOODS, BANGOR, ME 04401
(207) 942-1565
(207) 942-7430
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC749
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047526
ANTHEM
ME
Enumeration date
02/14/2007
Last updated
07/08/2007
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