Individual
MRS. MICHELLE J BERUBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
272 MAIN ST, MADAWASKA, MADAWASKA, ME 04756-1126
(207) 436-9587
Mailing address
272 MAIN ST, MADAWASKA, MADAWASKA, ME 04756-1126
(207) 436-9587
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11763
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432729699
—
ME
Enumeration date
10/29/2007
Last updated
05/10/2016
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