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General NPI Number Information
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NPI Number | 1962830323
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Entity Type | Individual
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Provider Name | JANET WILLIE L.P.N., L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 18 HIGH ST
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City | BETHEL
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State | ME
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Zip | 04217
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Country | US
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Telephone | 207-824-3889
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 944 18 HIGH STREET
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City | BETHEL
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State | ME
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Zip | 04217-0944
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Country | US
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Telephone | 207-824-3889
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN13076
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT9
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | MT9
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License Number State | CO
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