Individual
CHARLES BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
91 CRESTMONT RD, BANGOR, ME 04401-5811
(505) 819-7678
Mailing address
91 CRESTMONT RD, BANGOR, ME 04401-5811
(505) 819-7678
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0126121
NM
101YM0800X
Mental Health Counselor
CC4970
ME
Other
Enumeration date
09/28/2009
Last updated
01/08/2023
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