Individual
MS. GWENDOLYNE ELISSA TUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
66 STATE ST, PORTLAND, ME 04101-3751
(207) 871-7431
(207) 871-7457
Mailing address
PO BOX 797, PORTLAND, ME 04104-0797
(207) 871-7431
(207) 871-7457
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC15813
ME
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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