Individual
LYNN M TIJSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC,LADC,ACS
Contact information
Practice address
50 MOODY ST, SACO, ME 04072-1536
(207) 233-4174
Mailing address
PO BOX 804, GORHAM, ME 04038-0804
(207) 233-4174
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3698
ME
101YP2500X
Professional Counselor
Primary
CC2256
ME
Other
Enumeration date
11/18/2009
Last updated
12/23/2010
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