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Individual

JODI SUSANNE HARDWICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1 VA CENTER (MDP171), TOGUS VAMC, AUGUSTA, ME 04330
(207) 623-8411
(207) 626-4707
Mailing address
1 VA CENTER (MDP171), TOGUS VAMC, AUGUSTA, ME 04330
(207) 623-8411
(207) 626-4707

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12517
ME
106H00000X
Marriage & Family Therapist
MC10617
ME

Other

Enumeration date
09/15/2006
Last updated
05/24/2010
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