Individual
JENNIFER ANTHONY ROCHE OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
135 MAINE ST STE A423, BRUNSWICK, ME 04011-2098
(207) 945-1700
Mailing address
135 MAINE ST STE A423, BRUNSWICK, ME 04011-2098
(207) 945-1700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MC18087
ME
1041C0700X
Clinical Social Worker
Primary
LC20908
ME
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/31/2019
Last updated
04/19/2024
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