Provider Demographics
NPI:1447587597
Name:PLOUFFE, MARY E (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:PLOUFFE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:SOUTH FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04078-0424
Mailing Address - Country:US
Mailing Address - Phone:207-865-9607
Mailing Address - Fax:207-865-9607
Practice Address - Street 1:33 SPAR COVE ROAD
Practice Address - Street 2:
Practice Address - City:SO FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04078-0424
Practice Address - Country:US
Practice Address - Phone:207-865-9607
Practice Address - Fax:207-865-9607
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME433103TC0700X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling