Individual
BIANCA VANDERPOOL MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
123 FENWAY ST, PORTLAND, ME 04102-2404
(207) 450-1650
Mailing address
123 FENWAY ST, PORTLAND, ME 04102-2404
(207) 450-1650
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12714
ME
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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