Most Relevant Information
Provider Data
| NPI Number: | 1003396037 |
| Provider Name: | BRANDON L OUELLETTE LCPC-C |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | XL5091 |
Most Important Dates
| Enumeration Date: | 08/20/2018 |
| Last Updated: | 08/20/2018 |
Provider Practice Location
71 US ROUTE 1 STE G
SCARBOROUGH
ME
040747174
Practice Location Phone/Fax
| Phone: | 2077743570 |
| Fax: |
Provider Mailing Location
9 CARRIER WOOD RD APT 70
SCARBOROUGH
ME
040747190
Provider Mailing Phone/Fax
| Phone: | 2075517715 |
| Fax: |