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General NPI Number Information
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NPI Number | 1326854811
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Entity Type | Individual
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Provider Name | MARIA ROTHAUPT
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Gender | Female
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1 HARNOIS AVE
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City | WESTBROOK
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State | ME
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Zip | 04092-4392
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Country | US
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Telephone | 207-661-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 260 PARK AVE APT 3
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City | PORTLAND
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State | ME
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Zip | 04102-2932
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Country | US
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Telephone | 518-354-0956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MC24139
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License Number State | ME
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