Individual
LANA CLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 WATERBORO RD, ALFRED, ME 04002
(207) 324-8222
Mailing address
PO BOX 53, ALFRED, ME 04002-0053
(207) 324-8222
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC3505
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25750099
—
ME
Enumeration date
08/11/2006
Last updated
07/08/2007
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