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General NPI Number Information
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NPI Number | 1891874236
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Entity Type | Individual
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Provider Name | ELIZABETH JANE HENNEDY-FRIEL L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 890 PORTLAND RD SUITE 6
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City | SACO
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State | ME
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Zip | 04072-9600
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Country | US
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Telephone | 207-284-2145
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Fax | 207-284-6025
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Provider Business Mailing Address
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Address Line | 19 OCEANVIEW DR
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City | BIDDEFORD
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State | ME
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Zip | 04005-9555
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Country | US
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Telephone | 207-283-3651
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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 | LC2922
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License Number State | ME
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