Provider Demographics
NPI:1962973198
Name:OUELLETTE, MALORIE KAY (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MALORIE
Middle Name:KAY
Last Name:OUELLETTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BOOTHBY RD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:ME
Mailing Address - Zip Code:04253-3829
Mailing Address - Country:US
Mailing Address - Phone:207-577-6040
Mailing Address - Fax:207-753-1999
Practice Address - Street 1:137 EAST AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5627
Practice Address - Country:US
Practice Address - Phone:207-577-6040
Practice Address - Fax:207-753-1999
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXM5146106H00000X
MEMF6484106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist