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Individual

JENNY INGWERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
15 YORK ST BLDG 19, STE 201, BIDDEFORD, ME 04005-5507
(207) 871-1211
Mailing address
901 WASHINGTON AVE, PORTLAND, ME 04103-2737

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC4992
ME

Other

Enumeration date
10/16/2015
Last updated
11/09/2018
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