Individual
JENNIFER K STASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
181 BRACKETT ST, PORTLAND, ME 04102-3857
(207) 229-7912
Mailing address
181 BRACKETT ST, PORTLAND, ME 04102-3857
(207) 229-7912
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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