Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LC14555 | ME |
NPI | 1003243288 |
---|---|
Provider Name | Deanne M Jones |
First Address | Albany, NY 12201-5187 |
Second Address | Lewiston, ME 04240-6031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 27/08/2014 |