Individual
CHARISSA MARIE MAGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
261 FRENCH ST., BANGOR, ME 04401
(207) 991-4533
Mailing address
261 FRENCH ST., BANGOR, ME 04401
(207) 991-4533
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8400
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327860099
—
ME
01
—
LC8400
STATE LICENSE
ME
Enumeration date
02/07/2007
Last updated
02/15/2019
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