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William Blaine-wallace
Professional Counselor in Farmington, Maine
NPI 1730612839

William Blaine-wallace is a Professional Counselor based in Farmington, ME and is specialized in Professional. William Blaine-wallace practices in Farmington, ME. The NPI Number for William Blaine-wallace is 1730612839 and holds a License No. XP4415 (Maine).

The current practice location address for William Blaine-wallace is 456 New Vineyard Rd, Farmington, ME and can be reached out via phone at 207-491-9645.

Location: 456 New Vineyard Rd, Farmington, ME, 04938-5216
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730612839
Provider Name
William Blaine-wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
456 New Vineyard Rd, Farmington, ME, 04938-5216
Phone Number
207-491-9645
Fax Number
Provider Enumeration Date
04/05/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
456 New Vineyard Rd
City
Farmington
State
Maine
Zip
04938-5216
Phone Number
207-491-9645
Fax Number
person
Provider Business Mailing Address Details
Address
456 New Vineyard Rd
City
Farmington
State
Maine
Zip
04938-5216
Phone Number
207-491-9645
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
XP4415 (Maine)
Definition
Definition to come...
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