Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | MC16513 | ME |
NPI | 1003331380 |
---|---|
Provider Name | Nell S Woodworth |
First Address | Portland, ME 04103-2842 |
Second Address | Lewiston, ME 04240-7116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2017 |
Last Update Date | 08/08/2017 |