Individual
MRS. AMANDA STUPAKEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
304 HANCOCK ST, BANGOR, ME 04401-6573
(207) 989-5701
Mailing address
304 HANCOCK ST, BANGOR, ME 04401-6573
(207) 989-5701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12952
ME
1041C0700X
Clinical Social Worker
MC10851
ME
Other
Enumeration date
05/26/2009
Last updated
03/23/2012
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