Organization
THERAPEUTIC SPACE WITH LARA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARA NORDENSON (THERAPIST)
(207) 939-5080
Entity
Organization
Contact information
Practice address
602 BRIGHTON AVE, PORTLAND, ME 04102-2324
(207) 939-5080
Mailing address
38 DOUGLAS MTN RD, SEBAGO, ME 04029-3122
(207) 939-5080
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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