Individual
TRACEY LEE MINERVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
141 N MAIN ST STE 203, BREWER, ME 04412-2055
(207) 907-4343
(207) 907-4343
Mailing address
141 N MAIN ST STE 203, BREWER, ME 04412-2055
(207) 907-4343
(207) 907-4343
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC13255
ME
Other
Enumeration date
06/24/2008
Last updated
02/09/2015
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