Healthcare Provider Details

I. General information

NPI: 1447182506
Provider Name (Legal Business Name): STACIE ARSENAULT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 GORDON HILL RD
CHESTERVILLE ME
04938-3425
US

IV. Provider business mailing address

138 GORDON HILL RD
CHESTERVILLE ME
04938-3425
US

V. Phone/Fax

Practice location:
  • Phone: 207-615-4242
  • Fax:
Mailing address:
  • Phone: 207-615-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-55632
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: