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Individual

TIA R ROBERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW-CC

Contact information

Practice address
22 W COLE RD STE 103, BIDDEFORD, ME 04005-9431
(207) 571-9923
(207) 571-9927
Mailing address
22 W COLE RD STE 103, BIDDEFORD, ME 04005-9431
(207) 571-9923
(207) 571-9927

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LC12104
ME
1041C0700X
Clinical Social Worker
Primary
MC19706
ME

Other

Enumeration date
11/01/2021
Last updated
11/08/2021
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