Individual
MATHEW GERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SW-C
Contact information
Practice address
12 UNION ST, ROCKLAND, ME 04841-2739
(207) 701-4477
(207) 701-4485
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 842-6556
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSX11661
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433041299
—
ME
Enumeration date
10/21/2008
Last updated
10/19/2012
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