Individual
JASON H PICHETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW-CC
Contact information
Practice address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3000
Mailing address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC12618
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435859099
—
ME
Enumeration date
08/11/2010
Last updated
08/11/2010
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