Individual
AMANDA ELIZABETH DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DSP,CRMA
Contact information
Practice address
131 OAKLAND RD, FAIRFIELD, ME 04937-3229
(207) 453-9152
Mailing address
131 OAKLAND RD, FAIRFIELD, ME 04937-3229
(207) 453-9152
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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