Healthcare Provider Details

I. General information

NPI: 1689222531
Provider Name (Legal Business Name): ERIKA GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WESTBROOK COMMONS
WESTBROOK ME
04092
US

IV. Provider business mailing address

17 LYNDA RD
PORTLAND ME
04103-4918
US

V. Phone/Fax

Practice location:
  • Phone: 207-591-7210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: