Individual
KRISTINE D. LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
17 TINK DR, GORHAM, ME 04038-1343
(978) 210-1807
Mailing address
11 BAXTER BLVD FL 2, PORTLAND, ME 04101-1801
(603) 883-0005
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LCSW218627
MA
1041C0700X
Clinical Social Worker
Primary
LC17971
ME
Other
Enumeration date
05/21/2013
Last updated
09/27/2023
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