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Individual

MRS. LAURIE JOANNE GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
17 BRUNSWICK AVE, GARDINER, ME 04345-2123
(207) 462-0596
(207) 549-3198
Mailing address
17 BRUNSWICK AVE, GARDINER, ME 04345-2123
(207) 462-0596
(207) 549-3198

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10406
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431738699
ME
Enumeration date
09/25/2007
Last updated
09/25/2007
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