Individual
MISTY RENEE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
268 STILLWATER AVE, BANGOR, ME 04401-3945
(207) 973-9548
(207) 973-6437
Mailing address
268 STILLWATER AVE, PO BOX 422, BANGOR, ME 04401-3945
(207) 973-9548
(207) 973-6437
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC14516
ME
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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