Individual
MRS. MISTY L FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
40 SUMMER ST, BANGOR, ME 04401-6446
(207) 323-1635
Mailing address
48 ELM ST APT 1, BANGOR, ME 04401-5380
(207) 323-1635
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC13727
ME
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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