Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | CC4785 | ME |
NPI | 1003210345 |
---|---|
Provider Name | Megan R Berman |
First Address | Waterboro, ME 04087-0122 |
Second Address | Waterboro, ME 04087 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2014 |
Last Update Date | 27/02/2018 |