Individual
JOAN D KIERSTEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 GRAND ARMY RD, WHITEFIELD, ME 04353-3546
(207) 549-5019
Mailing address
PO BOX 171, WHITEFIELD, ME 04353-0171
(207) 549-5019
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135600000
—
ME
Enumeration date
05/12/2009
Last updated
05/12/2009
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