Individual
MISS STACEY L PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
61 MAIN ST STE 31, BANGOR, ME 04401-8300
(207) 299-5599
Mailing address
9 BLAISDELL RD, STETSON, ME 04488-3013
(207) 292-5599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC13699
ME
Other
Enumeration date
01/20/2008
Last updated
04/02/2014
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