Individual
MRS. DENISE MARIE NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
336 MOUNT HOPE AVE STE 17, BANGOR, ME 04401-4236
(207) 573-9011
(207) 922-9847
Mailing address
336 MOUNT HOPE AVE STE 17, BANGOR, ME 04401-4236
(207) 573-9011
(207) 922-9847
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC7406
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
327150099
—
ME
Enumeration date
04/23/2007
Last updated
04/03/2020
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