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Individual

MARIANNE FRICKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
268 STATE ST, ROOM 2-4, BANGOR, ME 04401-5417
(207) 990-0188
(207) 990-6604
Mailing address
268 STATE ST, ROOM 2-4, BANGOR, ME 04401-5417
(207) 990-0188
(207) 990-6604

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC7263
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100017
ANTHEM
ME
05
291250099
ME
01
332129
TRI-CARE
ME
01
7286556
AETNA
ME
Enumeration date
12/11/2006
Last updated
07/02/2008
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