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PATRICIA A CANAVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
162 MAIN ST, PRESQUE ISLE, ME 04769-2817
(207) 768-3304
(207) 764-6340
Mailing address
162 MAIN ST, PRESQUE ISLE, ME 04769-2817
(207) 768-3304
(207) 764-6340

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LC8211
ME
1041C0700X
Clinical Social Worker
Primary
LC8211
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093734345
ME
01
200828
ANTHEM
ME
01
9454062
AETNA
ME
Enumeration date
07/18/2006
Last updated
05/24/2013
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