Provider Demographics
NPI:1316381783
Name:ORDWAY, BRETT
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:ORDWAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 ROCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03901-2244
Mailing Address - Country:US
Mailing Address - Phone:207-415-8785
Mailing Address - Fax:
Practice Address - Street 1:86 ROCHESTER ST
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03901-2244
Practice Address - Country:US
Practice Address - Phone:207-415-8785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor