Individual
MR. TIGHE BLACKADAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
41 DEPOT ST STE 204, BRIDGTON, ME 04009-2298
(207) 241-4332
Mailing address
41 DEPOT ST STE 204, BRIDGTON, ME 04009-2298
(207) 241-4332
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC17781
ME
Other
Enumeration date
09/10/2020
Last updated
10/15/2024
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