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Individual

MS. COURTNEY P MISHOU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW-CC

Contact information

Practice address
254 STATE ST, BREWER, ME 04412-1519
(207) 989-2946
Mailing address
801 MAIN ROAD, BRADLEY, ME 04411
(207) 299-0588

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC13310
ME

Other

Enumeration date
11/04/2011
Last updated
11/04/2011
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