Individual
KATHLEEN FAY DEHAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
735 WILSON ST, BREWER, ME 04412-1000
(207) 989-1567
Mailing address
735 WILSON ST, BREWER, ME 04412-1000
(207) 989-1567
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC11610
ME
Other
Enumeration date
06/17/2008
Last updated
01/22/2013
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