Provider Information for 1659681492
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STEPHEN THOMAS DEXTER LCPC-C
Sex: Male
NPI: 1659681492
Last Updated: 2012-12-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1659681492 | ||||||||||||
| Enumeration Date | 2010-10-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 157 NOBLEBORO, ME 04555 United States Phone: 207-213-4616 | Fax: | ||||||||||||
| Primary Practice Address | 43 HOOPER ST. WISCASSET, ME 04578 United States Phone: 207-213-4616 | Fax: | ||||||||||||
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