Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor |
NPI | 1003212945 |
---|---|
Provider Name | Joan Reinholdtsen |
First Address | Bangor, ME 04401-5093 |
Second Address | Bangor, ME 04401-5093 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2014 |
Last Update Date | 13/04/2021 |