Provider Demographics
NPI:1194940643
Name:OUELLETTE, LOUISE R (LCPC)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:R
Last Name:OUELLETTE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WATER STREET
Mailing Address - Street 2:SUITE #4
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347-1505
Mailing Address - Country:US
Mailing Address - Phone:207-673-0664
Mailing Address - Fax:
Practice Address - Street 1:210 WATER STREET
Practice Address - Street 2:SUITE #4
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-1505
Practice Address - Country:US
Practice Address - Phone:207-673-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional