Individual
EILEEN G MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
735 WILSON ST, BREWER, ME 04412-1000
(207) 989-1567
(207) 989-2287
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 945-5247
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LS4281
ME
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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