Individual
MICHELLE SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
444 STILLWATER AVE, SUITE 204, BANGOR, ME 04401-3521
(207) 299-1414
Mailing address
444 STILLWATER AVE, SUITE 204, BANGOR, ME 04401-3521
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC15065
ME
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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