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Individual

MRS. PENNEY A. SIDDIQUI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
169 ACADEMY ST, PRESQUE ISLE, ME 04769-3167
(207) 551-1274
Mailing address
169 ACADEMY ST, PRESQUE ISLE, ME 04769-3167
(207) 551-1274

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8163
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
248180099
ME
Enumeration date
12/04/2006
Last updated
09/29/2014
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