Individual
SANDRA ELAINE JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW-C
Contact information
Practice address
28 STATE ST STE 5, GORHAM, ME 04038-1147
(207) 899-5822
Mailing address
28 STATE ST STE 5, GORHAM, ME 04038-1147
(207) 899-5822
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSX20975
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTHER
—
ME
Enumeration date
02/28/2022
Last updated
02/28/2022
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