Provider Demographics
NPI:1689968307
Name:DUMOND, STEPHANIE C,
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:C,
Last Name:DUMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SWEDEN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-2127
Mailing Address - Country:US
Mailing Address - Phone:204-493-3361
Mailing Address - Fax:207-492-4889
Practice Address - Street 1:24 SWEDEN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2127
Practice Address - Country:US
Practice Address - Phone:204-493-3361
Practice Address - Fax:207-492-4889
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor