Male or Other

Phillip Smith

Clinical Social Worker in Gorham, ME(View on Map)

Full Name

Phillip Smith

NPI Number

1790091973

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/25/2010

Specialties

(Taxonomies)

Code

1041C0700X

Primary Taxonomy

Yes

Licenses

State

Maine

License Number

LC3739

Contact
Information

Purpose

Mailing
Location

Address

313 OSSIPEE TRL
313 OSSIPEE TRL

City

Gorham
Gorham

State

ME
ME

Postal Code

04038-2131
04038-2131

Country

US
US

Telephone Number

(207) 929-0135
(207) 929-0135

Identifiers

Identifier

435655099

Identifier State

ME

Identifier Issuer

PROVIDER ENROLLMENT

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/25/2010

Provider Address

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