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1164068128
SAMANTHA BLACKADAR
SOUTH PORTLAND, ME
NPI
1164068128
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: LC18385)
Enumeration Date
2019-11-25
Last Update Date
2019-11-25
Business Address
SAMANTHA BLACKADAR LCSW, LICSW
100 GANNETT DR
SOUTH PORTLAND, ME 04106-5900
Phone number: 207-854-1030
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Mailing Address
SAMANTHA BLACKADAR LCSW, LICSW
46 EVANS ROAD
BRIDGTON, ME 04009
Phone number: 603-969-5317
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