Individual
RHODA JEAN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
25 ROTARY DR, SACO, ME 04072-9500
(207) 282-0695
Mailing address
25 ROTARY DR, SACO, ME 04072-9500
(207) 282-0695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10651
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
433327099
PROVIDER ENROLLMENT
ME
Enumeration date
08/25/2010
Last updated
08/13/2012
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