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General NPI Number Information
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NPI Number | 1437466430
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Entity Type | Individual
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Provider Name | PENNY GAUVIN LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/12/2010
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 39 LIMERICK RD 6U
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City | ARUNDEL
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State | ME
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Zip | 04046-8158
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Country | US
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Telephone | 207-590-3668
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Fax | 207-467-3490
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Provider Business Mailing Address
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Address Line | 12 TIBBETTS LN
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City | LYMAN
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State | ME
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Zip | 04002-7572
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Country | US
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Telephone | 207-590-3668
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Fax | 207-467-3490
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC2445
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License Number State | ME
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