Individual
MS. MARY JO STORMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 773-7993
Mailing address
205 OCEAN AVE, PORTLAND, ME 04103-5712
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC757
ME
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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