Individual
THERESA ANN WING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 MOLLISON WAY, LEWISTON, ME 04240-5811
(207) 312-6860
Mailing address
PO BOX 182, LISBON FALLS, ME 04252-0182
(207) 754-0411
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN45167
ME
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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