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Individual

MRS. SHELBY ANN THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
175 AUBURN STREET, PORTLAND, ME 04103
(207) 874-8215
(207) 874-8218
Mailing address
58 QUAIL TRAIL, BUXTON, ME 04093
(207) 512-2600
(207) 874-8218

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10924
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431686199
ME
Enumeration date
03/22/2007
Last updated
07/08/2007
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