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Search › Maine › 104100000X

Theresa Puckett

NPI 1386934107 · on the registry since 2011 · sole proprietor

Practice

Address
92 Deering Ave
Portland, ME 04102
Phone
(207) 874-8104
Fax
(207) 874-8290
Organisation at this address
Portland Community Health Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address
2

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
ME
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2011-04-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maine