Provider Information for 1427183086
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Mrs. LAURA JANE HENCKLER LCSW
Other Names:Former Name:Miss LAURA JANE MIDDLETON LSWSex: Female
NPI: 1427183086
Last Updated: 2013-06-18
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1427183086 | ||||||||
| Enumeration Date | 2007-02-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 78 ATLANTIC PLACE SOUTH PORTLAND, ME 04106-2316 United States Phone: 207-842-7701 | Fax:207-842-7773 | ||||||||
| Primary Practice Address | 453 US ROUTE 1 KITTERY, ME 03904-5513 United States Phone: 207-451-1750 | Fax:207-439-4360 | ||||||||
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