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General NPI Number Information
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NPI Number | 1851876320
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Entity Type | Organization
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Legal Business Name | AURA RUSSELL-BEDDER, LCSW, LLC
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 8 ARCADIA ST
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City | PORTLAND
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State | ME
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Zip | 04103-5402
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Country | US
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Telephone | 207-318-2915
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Fax |
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Provider Business Mailing Address
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Address Line | 8 ARCADIA ST
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City | PORTLAND
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State | ME
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Zip | 04103-5402
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Country | US
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Telephone | 207-318-2915
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AURA RUSSELL-BEDDER
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Credential | LCSW
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Telephone | 207-318-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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