Doctor Name: | NICOLETTE W. YERXA |
NPI Number: | 1053658294 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHRT-CSP |
License Number: | |
Business Practice Address: | 1 Stackpole Dr Machias, ME - 046547000 |
Business Phone Number: | 2072550996 |
Business Fax Number: | 2072558748 |
Mailing Address: | 1 Stackpole Dr, MACHIAS |
State: | ME |
Postal Code: | 046547000 |
Phone Number: | 2072550996 |
Fax Number: | 2072558748 |
NPI Enumeration Date: | 01/08/2013 |
NPI Last Update Date: | 01/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |