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Individual

MS. EDITHE ANNE GAGNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, DCSW

Contact information

Practice address
157 PARK ST, SUITE 35, BANGOR, ME 04401-5093
(207) 945-3911
Mailing address
91 SUMMER ST, HAMPDEN, ME 04444-1211
(207) 862-6311

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC7700
ME

Other

Enumeration date
12/13/2006
Last updated
07/08/2007
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