Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LC11217 | ME |
NPI | 1003001272 |
---|---|
Provider Name | Mrs. Deanne E Ochoa-Durrell |
First Address | Livermore Falls, ME 04254-1231 |
Second Address | Rumford, ME 04276-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 11/09/2007 |