Most Relevant Information
Provider Data
| NPI Number: | 1003011487 |
| Provider Name: | JEAN MARIE WAKEM LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | LC7318 |
Most Important Dates
| Enumeration Date: | 06/18/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
253 NORTHPORT AVE
BELFAST
ME
049156006
Practice Location Phone/Fax
| Phone: | 2073384514 |
| Fax: |
Provider Mailing Location
95 SIROTA DR
SEARSMONT
ME
049733323
Provider Mailing Phone/Fax
| Phone: | 2073425387 |
| Fax: |