| Doctor Name: | MS. LANA M PELLETIER |
| NPI Number: | 1629225305 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | 10017 |
| Business Practice Address: | 96 Market St Fort Kent, ME - 047431453 |
| Business Phone Number: | 2078343186 |
| Business Fax Number: | |
| Mailing Address: | 167 Allagash Rd, ALLAGASH |
| State: | ME |
| Postal Code: | 047744001 |
| Phone Number: | 2073984081 |
| Fax Number: | |
| NPI Enumeration Date: | 08/25/2008 |
| NPI Last Update Date: | 08/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 10017 |
| 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 |