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NPI 1992920706

NPI 1992920706 : JUDITH E ERMINGER LCPC : LEWISTON, ME

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General NPI Number Information
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    NPI Number           |    1992920706
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    Entity Type          |    Individual 
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    Provider Name        |    JUDITH E ERMINGER LCPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/16/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    35 WESTMINSTER STREET SUITE B
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    City                 |    LEWISTON
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    State                |    ME
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    Zip                  |    04240
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    Country              |    US
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    Telephone            |    207-786-8122
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    Fax                  |    207-786-8164
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Provider Business Mailing Address
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    Address Line         |    PO BOX 787 
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    City                 |    ELLSWORTH
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    State                |    ME
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    Zip                  |    04605-0787
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    Country              |    US
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    Telephone            |    207-667-0909
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    Fax                  |    207-667-6348
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    CC2724
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    License Number State |    ME
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