Doctor Name: | MICHELE PAULA MANNION |
NPI Number: | 1053599191 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | CC2704 |
Business Practice Address: | 120 Tillson Ave Ste 214 Rockland, ME - 048413400 |
Business Phone Number: | 2079753289 |
Business Fax Number: | |
Mailing Address: | 120 Tillson Ave Ste 214, ROCKLAND |
State: | ME |
Postal Code: | 048413400 |
Phone Number: | 2079753289 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2008 |
NPI Last Update Date: | 08/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CC2704 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |