Individual
SUSAN LOBOSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 INDIA ST, PORTLAND, ME 04101-4211
(207) 272-6855
(207) 775-2255
Mailing address
100 BRICKHILL AVE, MAPS-LOWER LEVEL, S PORTLAND, ME 04106-1999
(207) 272-6853
(207) 775-2255
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC11302
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435409099
—
ME
Enumeration date
04/14/2010
Last updated
04/14/2010
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