Individual
MAURA TUKEY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
180 HATCH RD, NEW GLOUCESTER, ME 04260-3663
(207) 926-5021
Mailing address
180 HATCH RD, NEW GLOUCESTER, ME 04260-3663
(207) 926-5021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC11088
ME
1041C0700X
Clinical Social Worker
Primary
LC11088
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31686
HEALTH NEW ENGLAND
MA
Enumeration date
07/17/2006
Last updated
11/04/2010
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