Individual
KERISH N BENTTINEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
32 COLLEGE AVE, SUITE 206, WATERVILLE, ME 04901-6100
(207) 680-2065
(207) 680-2068
Mailing address
32 COLLEGE AVE, SUITE 206, WATERVILLE, ME 04901-6100
(207) 680-2065
(207) 680-2068
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC13117
ME
1041C0700X
Clinical Social Worker
MC12063
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730316910
—
ME
Enumeration date
06/16/2009
Last updated
12/27/2011
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