Individual
MS. MARY BETH WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
501 FOREST AVE, PORTLAND, ME 04101-1503
(207) 536-1590
(207) 536-1591
Mailing address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-9141
(207) 536-1591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC21155
ME
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/02/2018
Last updated
08/30/2022
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