Individual
ELIZABETH R SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
157 PARK ST, SUITE 35, BANGOR, ME 04401-5093
(207) 992-9454
Mailing address
157 PARK ST, SUITE 35, BANGOR, ME 04401-5093
(207) 992-9454
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11594
ME
Other
Enumeration date
09/24/2008
Last updated
06/27/2011
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