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Individual

KRISTEN RECORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW-CC

Contact information

Practice address
640 BRIGHTON AVE, PORTLAND, ME 04102-1047
(207) 494-8010
(207) 494-8471
Mailing address
275 MAIN ST STE 205, BIDDEFORD, ME 04005-2432
(207) 494-8010
(207) 494-8471

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC17229
ME

Other

Enumeration date
10/11/2018
Last updated
10/11/2018
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