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General NPI Number Information
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NPI Number | 1609356567
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Entity Type | Individual
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Provider Name | EMILY MARRON WEBSTER
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Gender | Female
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 100 GANNETT DR
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-5900
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Country | US
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Telephone | 207-289-7213
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MILL RIDGE RD
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City | CUMBERLAND
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State | ME
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Zip | 04021-3132
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Country | US
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Telephone | 207-754-3530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC18498
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MC17302
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License Number State | ME
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