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General NPI Number Information
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NPI Number | 1396465530
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Entity Type | Organization
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Legal Business Name | PATRICIA SIRAGUSA ENGDAHL LCSW, LLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 444 MAIN ST
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City | LEWISTON
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State | ME
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Zip | 04240-6737
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Country | US
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Telephone | 207-431-4718
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Fax |
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Provider Business Mailing Address
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Address Line | 444 MAIN ST
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City | LEWISTON
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State | ME
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Zip | 04240-6737
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Country | US
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Telephone | 207-431-4718
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PATRICIA SIRAGUSA ENGDAHL
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Credential |
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Telephone | 207-431-4718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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