Individual
MRS. SAMANTHA MICHELLE RUNCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, MED
Contact information
Practice address
24 MORTLAND RD, SEARSPORT, ME 04974-6311
(207) 548-2311
Mailing address
198 KENNEBEC RD, HAMPDEN, ME 04444-1318
(207) 862-3256
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
LS8299
ME
Other
Enumeration date
03/24/2011
Last updated
03/24/2011
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