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Individual

MR. RUDOLPH ALBERT SKOWRONSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
199 MAIN ST FL 3, SACO, ME 04072-1508
(207) 776-8245
(207) 571-3263
Mailing address
276 BACK RD, ALFRED, ME 04002-3289
(077) 768-2452
(207) 571-3263

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6729
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2120621
CIGNA PROVIDER NUMBER
ME
01
7173577000
MAGELLAN PROVIDER NUMBER
ME
Enumeration date
06/21/2006
Last updated
08/29/2022
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