| Therapeutic Space With Lara | |
|
602 Brighton Ave Portland ME 04102-2324 | |
| (207) 939-5080 | |
| Not Available |
| Full Name | Therapeutic Space With Lara |
|---|---|
| Speciality | Social Worker |
| Location | 602 Brighton Ave, Portland, Maine |
| Authorized Official Name and Position | Lara Nordenson (THERAPIST) |
| Authorized Official Contact | 2079395080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Space With Lara 38 Douglas Mtn Rd Sebago ME 04029-3122 Ph: (207) 939-5080 | Therapeutic Space With Lara 602 Brighton Ave Portland ME 04102-2324 Ph: (207) 939-5080 |
| NPI Number | 1891525622 |
|---|---|
| Provider Enumeration Date | 08/06/2024 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891525622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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