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Individual

WILMA E WAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
37 BRANCH RD, KENNEBUNK, ME 04043-6401
(207) 329-9730
Mailing address
37 BRANCH RD, KENNEBUNK, ME 04043-6401
(207) 329-9730

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC9447
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432141799
ME
01
LC9447
STATE LICENSE NUMBER
ME
Enumeration date
12/27/2006
Last updated
12/08/2015
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