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Individual

CELESTE V REED HANISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
319 UNION ST, BANGOR, ME 04401-4607
(207) 478-1562
(207) 862-5393
Mailing address
21 SUMMER ST, HAMPDEN, ME 04444-1209
(207) 478-1562
(207) 862-5393

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC6917
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
098304
ANTHEM LEGACY NUMBER
ME
Enumeration date
05/30/2006
Last updated
11/29/2007
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