Individual
MR. MICHAEL ARTHUR FASULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2 WATER ST, SUITE 2, HOULTON, ME 04730-2126
(207) 532-5510
(207) 532-5518
Mailing address
27 MAPLE ST, HOULTON, ME 04730-1826
(207) 532-2631
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC493
ME
Other
Enumeration date
05/16/2007
Last updated
07/09/2007
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