Individual
SAMMANTHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 FOREST AVE, PORTLAND, ME 04101-1503
(207) 536-1590
Mailing address
501 FOREST AVE, PORTLAND, ME 04101-1503
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC18872
ME
Other
Enumeration date
05/12/2021
Last updated
05/12/2021
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