Individual
HEATHER KINGSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
34 CARTER ST, SOUTH PORTLAND, ME 04106-2713
(207) 650-1530
Mailing address
34 CARTER ST, SOUTH PORTLAND, ME 04106-2713
(207) 650-1530
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC244
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099144
BLUE CROSS BLUE SHIELD
ME
Enumeration date
04/11/2007
Last updated
05/10/2012
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