Willis, Alicia M

Willis, Alicia M is an individual health care provider with primary practice located at 17 Bishop St , Portland ME 04103-2659. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Willis, Alicia M can be contacted via phone (207) 871-1235.

Contact Information

Primary practice address
17 Bishop St Portland ME 04103-2659
Fax: (207) 879-6161
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CAC2998 Maine

Profile Details

NPI number 1003986340
LBN Legal business name Willis, Alicia M
Credentials CAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003986340 NPPES
Maine Other RB9 ANTHEM

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