Provider Information for 1790910735
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Ms. NICHOLE PROULX LMFT
Sex: Female
NPI: 1790910735
Last Updated: 2023-06-08
Certification Date: 2023-06-08
Certification Date: 2023-06-08
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1790910735 | ||||||||||||
| Enumeration Date | 2009-05-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 692 W OLD TOWN RD OLD TOWN, ME 04468-5715 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 1 COLLEGE CIR BANGOR, ME 04401-2929 United States Phone: 207-941-7990 | Fax: | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|