Individual
LISA ANNE FIDLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
656 STATE ST, BANGOR, ME 04401-5609
(207) 941-4036
(207) 941-4062
Mailing address
10 WALTER ST, BANGOR, ME 04401-6232
(207) 941-4321
(207) 941-4207
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10439
ME
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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