Individual
LAURIENNE MISSUD MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
155 ELM ST, NORTH BERWICK, ME 03906-7100
(207) 651-7573
Mailing address
155 ELM ST, NORTH BERWICK, ME 03906-7100
(207) 651-7573
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4443
ME
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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