Individual
DEBRA L HANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
27 MIDDLE ST, PORTLAND, ME 04101-4212
(207) 774-2362
Mailing address
321 AUBURN ST, PORTLAND, ME 04103-2122
(207) 797-6159
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1168
ME
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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