Individual
MARIA A MOUSTROUPHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Contact information
Practice address
77 VERMONT AVE, PORTLAND, ME 04103-3922
(207) 409-9487
Mailing address
77 VERMONT AVE, PORTLAND, ME 04103-3922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ME317297
ME
1041C0700X
Clinical Social Worker
Primary
ME324956
ME
Other
Enumeration date
05/01/2007
Last updated
11/05/2021
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