Individual
JAMIE RAE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
411 CONGRESS ST, PORTLAND, ME 04101-3505
(207) 405-0433
Mailing address
411 CONGRESS ST, PORTLAND, ME 04101-3505
(207) 405-0433
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-36745
ID
Other
Enumeration date
08/09/2017
Last updated
03/15/2023
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