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MR. TRISTRAM HEYWARD DASHTI-GIBSON LMHC

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1588729990

Individual Registrant:
MR. TRISTRAM HEYWARD DASHTI-GIBSON LMHC
Gender: M
Sole Proprietor

Location and contact information for practice:
196 OLD RD  ELIOT, ME 03903-1347 US
Tel: 574-904-2620  Fax: --

Contact information for business:
196 OLD RD  ELIOT, ME 03903-1347 US
Tel: 574-904-2620  Fax: --

Registration Information:
NPI: 1588729990
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
IN39001313A

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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