Individual
MRS. SUSAN KELLY SOCTOMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
42 CEDAR ST, BANGOR, ME 04401-6433
(207) 947-0366
Mailing address
1013 HUDSON RD, GLENBURN, ME 04401-1623
(207) 945-3275
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5210
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325750099
—
ME
Enumeration date
05/24/2007
Last updated
11/20/2019
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