Individual
MARK MAKSIMOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
114 BRACKETT RD, NORWAY, ME 04268-5337
(207) 776-3342
Mailing address
114 BRACKETT RD, NORWAY, ME 04268-5337
(207) 776-3342
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12860
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324300099
—
ME
Enumeration date
03/23/2006
Last updated
10/05/2015
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