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General NPI Number Information
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NPI Number | 1215709167
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Entity Type | Organization
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Legal Business Name | KATHLEEN MAY DANFORTH
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 284 MAIN ST STE 160
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City | WILTON
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State | ME
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Zip | 04294-3047
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Country | US
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Telephone | 207-645-2781
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Fax |
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Provider Business Mailing Address
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Address Line | 176 LAKE RD
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City | WILTON
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State | ME
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Zip | 04294-5301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/LCPC
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Name | KATHLEEN DANFORTH
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Credential | LCPC
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Telephone | 207-645-2781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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