Individual
MARY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW-LCSW
Contact information
Practice address
92 BENNETT DR, CARIBOU, ME 04736-1952
(207) 493-5210
(207) 493-5209
Mailing address
92 BENNETT DR, CARIBOU, ME 04736-1952
(207) 493-5210
(207) 493-5209
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5672
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248890099
—
ME
Enumeration date
08/20/2006
Last updated
12/18/2019
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