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Individual

LORRAINE O WIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
178 LISBON ST, LEWISTON, ME 04240-7234
(207) 440-3284
Mailing address
2 MILLER RD, LISBON, ME 04250-6245
(207) 440-3248

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8317
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
261000099
ME
01
RB9
ANTHEM
ME
Enumeration date
10/13/2006
Last updated
01/23/2012
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