| Organization Name: | LIFE BY DESIGN, PA |
| NPI Number: | 1053345918 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH A GRAY (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 37 Bangor St Ste 8 Houlton |
| State: | ME US |
| Postal Code: | 047301739 |
| Phone Number: | 2075329660 |
| Fax Number: | 2075329640 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 429704 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |