Individual
CAROLYN D WYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
1011 FOREST AVE, PORTLAND, ME 04103-3304
(800) 434-3000
Mailing address
47 WYLIE ST, SOUTH PORTLAND, ME 04106-4459
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL2569
ME
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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