Individual
MARCIA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
196 PINE ST, PORTLAND, ME 04102-3516
(207) 774-4448
Mailing address
196 PINE ST, PORTLAND, ME 04102-3516
(207) 774-4448
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5092
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038435
BLUE CROSS BLUE SHIELD
ME
01
—
7528368
AETNA
ME
Enumeration date
11/24/2006
Last updated
07/08/2007
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