Individual
SUSAN S STICKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
333 LINCOLN ST, SACO, ME 04072-3113
(207) 333-0476
Mailing address
1397 ROYALSBOROUGH RD, DURHAM, ME 04222-5231
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC13027
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244250099
—
ME
Enumeration date
08/08/2006
Last updated
10/12/2011
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