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Individual

THOMAS WALTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
100 WATERMAN DR STE 201, SOUTH PORTLAND, ME 04106-2880
(207) 699-4500
(207) 799-1350
Mailing address
100 WATERMAN DR STE 201, SOUTH PORTLAND, ME 04106-2880
(207) 699-4500
(207) 799-1350

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC15229
ME

Other

Enumeration date
09/25/2015
Last updated
03/17/2018
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