Individual
CASSIE ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
181 BRACKETT ST, PORTLAND, ME 04102-3857
(207) 775-0105
(207) 775-1392
Mailing address
181 BRACKETT ST, PORTLAND, ME 04102-3857
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
LS6183
ME
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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