Individual
MRS. KATIE MARIE SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 FOREST AVE, SUITE 9, PORTLAND, ME 04101-1541
(207) 838-6088
Mailing address
314 LUDLOW ST, PORTLAND, ME 04102-1810
(207) 774-0838
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11740
ME
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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