Individual
JESSICA C WALLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 NORTH ST, SACO, ME 04072-1843
(207) 590-4310
Mailing address
PO BOX 12, SACO, ME 04072-0012
(207) 590-4310
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
XL5141
ME
101YP2500X
Professional Counselor
Primary
CC5729
ME
Other
Enumeration date
11/14/2018
Last updated
11/29/2023
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