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General NPI Number Information
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NPI Number | 1275892689
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Entity Type | Organization
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Legal Business Name | AND BREATHE,LLC
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Dates
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Enumeration Date | 05/07/2012
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Last Update Date | 04/02/2013
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Provider Practice Location Address
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Address Line | 47 PORTLAND ST 2ND FL.
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City | PORTLAND
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State | ME
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Zip | 04101-3188
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Country | US
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Telephone | 207-274-9639
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Fax |
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Provider Business Mailing Address
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Address Line | 95 PARKER ST
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City | NEWBURYPORT
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State | MA
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Zip | 01950-4033
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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
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Name | SHANNYN VICENTE
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Credential |
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Telephone | 207-274-9639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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