Cody Larusso LCPC

NPI 1568695260 - Counselor - 101YP2500X

NPI Details
NPI 1568695260
Gender Male
Enumeration Date 08/27/2009
Last Updated 08/28/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
NEWPORT ME, 04953-4004, US
Phone (207) 368-2072
Fax (207) 368-5290
Business Location
BANGOR ME, 04401-4909, US
Phone (207) 942-3816
Fax (207) 561-4725
Taxonomy Code 101YP2500X
License State Maine
License Number CC542
Remove 1568695260 NPI Number

According to our database, Cody Larusso LCPC NPI is 1568695260, taxonomy code is 101YP2500X and license number is CC542, license state is located at Maine. Cody Larusso LCPC physically located at 442 Moosehead Trl, Newport ME, 04953-4004. NPI Number Cody Larusso LCPC has the Individual type.

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1568695260 NPI number is provided on an as is basis without warranty of any kind. 1568695260 is maintained by the National Plan & Provider Enumeration System. The contents of Cody Larusso LCPC are for informational purposes only.