Organization
LAURA GOTTFRIED LCSW INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA GOTTFRIED (PROVIDER OWNER)
(207) 773-0073
Entity
Organization
Contact information
Practice address
145 NEWBURY ST STE 2, PORTLAND, ME 04101-4261
(207) 773-0073
Mailing address
145 NEWBURY ST STE 2, PORTLAND, ME 04101-4261
(207) 773-0073
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669584058
—
ME
Enumeration date
10/13/2020
Last updated
10/13/2020
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