Individual
PRIYADARSHI GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1227 PRESCOTT RD, MANCHESTER, ME 04351-3010
(207) 623-2180
Mailing address
1227 PRESCOTT RD, MANCHESTER, ME 04351-3010
(207) 623-2180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1689
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
ME
Enumeration date
12/04/2014
Last updated
12/16/2020
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