Individual
MS. MARY BETH H SUNENBLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
95 INDIA STREET, PORTLAND, ME 04101
(207) 775-4199
Mailing address
6 PINE STREET, SOUTH PORTLAND, ME 04106
(207) 775-4199
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC967
ME
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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