Doctor Name: | JUSTINE NICOLE FRASER |
NPI Number: | 1144602343 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | MC15453 |
Business Practice Address: | 71 Us Route 1 Scarborough, ME - 040747173 |
Business Phone Number: | 2072198011 |
Business Fax Number: | |
Mailing Address: | 71 Us Route 1, SCARBOROUGH |
State: | ME |
Postal Code: | 040747173 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/24/2015 |
NPI Last Update Date: | 06/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | MC15453 |
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 |