Individual
LISABETH ETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
31 WALKER AVE, KITTERY, ME 03904-1525
(207) 752-7230
Mailing address
31 WALKER AVENUE, KITTERY, ME 03904
(207) 752-7230
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0082841
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201079803
PRESBY
—
05
—
G9368
—
NM
Enumeration date
12/05/2006
Last updated
01/19/2010
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