Individual
MALLORY ZWERDLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCPCC
Contact information
Practice address
52 BOLTON ST, PORTLAND, ME 04102-2502
(207) 479-7841
Mailing address
52 BOLTON ST, PORTLAND, ME 04102-2502
(207) 479-7841
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
XL5296
ME
101YM0800X
Mental Health Counselor
XL5296
ME
101YP2500X
Professional Counselor
Primary
XL5296
ME
102L00000X
Psychoanalyst
XL5296
ME
Other
Enumeration date
07/25/2019
Last updated
01/31/2020
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