Individual
KRISTIEN KEOWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 MOODY STREET, PORTLAND, ME 04072
(207) 294-4949
Mailing address
50 MOODY ST, SACO, ME 04072-1536
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC3949
ME
101YP2500X
Professional Counselor
7156525
UT
Other
Enumeration date
04/13/2011
Last updated
05/10/2012
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