Individual
MS. L.ANNA RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
11 BAXTER BLVD FL 2, PORTLAND, ME 04101-1801
(036) 883-0005
Mailing address
11 BAXTER BLVD FL 2, PORTLAND, ME 04101-1801
(603) 883-0005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
XL3431
ME
101YP2500X
Professional Counselor
Primary
CC4327
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2121RAVEN
—
ME
Enumeration date
08/07/2009
Last updated
09/19/2023
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