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Individual

MS. KRISTIN M SHULMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
12 ANDOVER RD, PORTLAND, ME 04102-1954
(207) 761-5612
(207) 662-6234
Mailing address
12 ANDOVER RD, PORTLAND, ME 04102-1954
(207) 761-5612
(207) 662-6234

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
ISW01638
RI
1041C0700X
Clinical Social Worker
Primary
LC12764
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31298-1
BCBSRI
RI
01
413281
BLUECHIP
RI
05
KM59768
RI
Enumeration date
03/15/2006
Last updated
05/14/2013
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