Individual
CAROLYN BALCOM HOLBROOK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
205 OCEAN AVE, PORTLAND, ME 04103-5742
(207) 775-1335
Mailing address
205 OCEAN AVE, PORTLAND, ME 04103-5742
(207) 775-1335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC2568
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048028
BC/BS
ME
Enumeration date
06/17/2006
Last updated
07/08/2007
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