Individual
LYDIA SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
50 MOODY ST, SACO, ME 04072
(800) 434-3000
Mailing address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC21049
ME
1041C0700X
Clinical Social Worker
MC18119
ME
Other
Enumeration date
08/08/2013
Last updated
04/26/2022
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