Provider Demographics
NPI:1154487437
Name:RICE, MINDY L (LCPC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:L
Last Name:RICE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MOUNT HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4057
Mailing Address - Country:US
Mailing Address - Phone:207-942-0125
Mailing Address - Fax:
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-973-7359
Practice Address - Fax:207-973-7674
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1683170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS