Most Relevant Information
Provider Data
| NPI Number: | 1003180944 |
| Provider Name: | MICA T. SLAVEN-LAMOTHE LCSW, MHRT-CSP |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/23/2012 |
| Last Updated: | 08/20/2014 |
Provider Practice Location
710 BUCKSPORT RD
ELLSWORTH
ME
046052722
Practice Location Phone/Fax
| Phone: | 2076676890 |
| Fax: | 2076876457 |
Provider Mailing Location
710 BUCKSPORT RD
ELLSWORTH
ME
046052722
Provider Mailing Phone/Fax
| Phone: | 2076676890 |
| Fax: | 2076876457 |