Healthcare Provider Details
I. General information
NPI: 1427176734
Provider Name (Legal Business Name): ANN R. ESCKILSEN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24 SWEDEN ST
CARIBOU ME
04736-2127
US
IV. Provider business mailing address
24 SWEDEN ST
CARIBOU ME
04736-2127
US
V. Phone/Fax
- Phone: 207-493-3361
- Fax: 207-492-4889
- Phone: 207-493-3361
- Fax: 207-492-4889
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | MC10951 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: