Individual
MRS. SUSAN BLACKWELL SOULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
500 ROUTE 1, SUITE 29C, YARMOUTH, ME 04096-4711
(207) 846-0186
Mailing address
500 ROUTE 1, SUITE 29C, YARMOUTH, ME 04096-4711
(207) 846-0186
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1324
ME
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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