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Individual

MARIA D LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4807
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4807

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6342
ME

Other

Enumeration date
01/16/2008
Last updated
04/05/2011
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