Most Relevant Information
Provider Data
| NPI Number: | 1003459231 |
| Provider Name: | ALICIA LYN SOUCY PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | CNP191268 |
Most Important Dates
| Enumeration Date: | 10/21/2019 |
| Last Updated: | 09/24/2024 |
Provider Practice Location
45 CHURCH ST
WALLAGRASS
ME
047813039
Practice Location Phone/Fax
| Phone: | 2072310037 |
| Fax: | 2078001004 |
Provider Mailing Location
45 CHURCH ST
WALLAGRASS
ME
047813039
Provider Mailing Phone/Fax
| Phone: | 2078147980 |
| Fax: | 2078001004 |