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Individual

BRITTANY LEIGH LOCKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1486 BROADWAY, UNIT B, SOUTH PORTLAND, ME 04106-2602
(207) 200-1373
(866) 861-9126
Mailing address
50 MOODY ST, SACO, ME 04072-1536
(800) 434-3000
(207) 294-4649

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC14149
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102010102
ME
Enumeration date
07/12/2011
Last updated
09/10/2013
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