Individual
MS. STEPHANIE G. MALCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
65 TOPSHAM FAIR MALL RD STE 2, TOPSHAM, ME 04086-1763
(207) 841-7111
Mailing address
1030 WEST RD, BOWDOIN, ME 04287-7043
(207) 841-7111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC13021
ME
1041C0700X
Clinical Social Worker
MC12236
ME
Other
Enumeration date
09/09/2009
Last updated
06/11/2019
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