Individual
DIANE NAOMI PELLETIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
27 GORHAM RD STE 6, SCARBOROUGH, ME 04074-8388
(207) 076-1408
Mailing address
PO BOX 282, SCARBOROUGH, ME 04070-0282
(207) 883-6745
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6536
ME
Other
Enumeration date
10/23/2006
Last updated
01/18/2024
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