Individual
MS. CORRINE ANNETTE BONGIOVANNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
836 MAIN ST, WESTBROOK, ME 04092-2861
(207) 240-3079
Mailing address
185 HIGHLAND CLIFF RD, WINDHAM, ME 04062
(207) 240-3079
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
668
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048258
ANTHEM BLUE CROSS-BLUE SH
ME
01
—
ME 668
ME CLINICAL LICESURE NO.
ME
Enumeration date
03/27/2007
Last updated
07/08/2007
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