Individual
RAE ELLEN SNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 BACON RD, CHARLESTON, ME 04422-3212
(207) 285-3842
Mailing address
21 BACON RD, CHARLESTON, ME 04422-3212
(207) 285-3842
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
ALLS 1363
ME
Other
Enumeration date
01/25/2007
Last updated
07/09/2007
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