Individual
MARY SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
176 LIVERMORE FALLS RD, STE A, FARMINGTON, ME 04938-6243
(207) 512-4801
(207) 778-4939
Mailing address
176 LIVERMORE FALLS RD, STE A, FARMINGTON, ME 04938-6243
(207) 512-4801
(207) 778-4939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6846
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431894599
—
ME
Enumeration date
08/10/2006
Last updated
08/22/2009
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