Individual
STEPHANIE JANDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHRT-CSP
Contact information
Practice address
104 E MAIN ST, FORT KENT, ME 04743
(207) 834-3186
(207) 834-7190
Mailing address
104 E MAIN ST, FORT KENT, ME 04743-1407
(207) 834-3186
(207) 834-7190
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972900652
—
ME
Enumeration date
11/25/2014
Last updated
06/07/2018
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