Individual
KIRSTEN LOUISE JETTINGHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
100 GRAY RD, FALMOUTH, ME 04105-2018
(207) 671-4325
Mailing address
14 PINEWOOD DR, CUMBERLAND, ME 04021-4043
(207) 671-4325
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC2729
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431730699
—
ME
Enumeration date
10/04/2006
Last updated
08/06/2009
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