Individual
SUNDARAM DAVID STANLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2 SPRINGBROOK DR, BIDDEFORD, ME 04005-9443
(207) 282-1500
(207) 282-2581
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LC15926
ME
104100000X
Social Worker
MC13917
ME
Other
Enumeration date
03/14/2014
Last updated
10/23/2019
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