Individual
ERNESTINE M PERREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, CCS
Contact information
Practice address
235 MAIN ST, NORWAY, ME 04268-5943
(207) 739-2644
Mailing address
235 MAIN ST, NORWAY, ME 04268-5943
(207) 739-2644
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC3536
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC3536
PROVIDER LICENSE NUMBER
ME
Enumeration date
05/25/2006
Last updated
03/17/2018
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