Doctor Name: | MS. MARY GRAY PITKIN |
NPI Number: | 1265558522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.P.C. |
License Number: | CC2134 |
Business Practice Address: | 27 River Rd Newcastle, ME - 045533845 |
Business Phone Number: | 2075635388 |
Business Fax Number: | |
Mailing Address: | Po Box 1055, DAMARISCOTTA |
State: | ME |
Postal Code: | 045431055 |
Phone Number: | 2075635388 |
Fax Number: | |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CC2134 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |