Individual
KRISTEN STAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
399 FORE ST STE 8, PORTLAND, ME 04101-4388
(207) 219-0692
Mailing address
93 CONCORD ST APT 2, PORTLAND, ME 04103-3175
(207) 219-0692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
XL5311
ME
Other
Enumeration date
05/23/2016
Last updated
12/20/2022
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