Organization
PINE STATE TELEHEALTH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY STANTON LCSW (OWNER)
(207) 209-3123
Entity
Organization
Contact information
Practice address
110 WILDERNESS LN, BOWDOINHAM, ME 04008-6059
(207) 209-3123
Mailing address
PO BOX 231, RICHMOND, ME 04357-0231
(207) 209-3123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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