Individual
AMANDA VANTASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LCMHC
Contact information
Practice address
575 FOREST AVE, PORTLAND, ME 04101-1513
(207) 772-1187
(207) 772-0974
Mailing address
575 FOREST AVE, PORTLAND, ME 04101-1513
(207) 772-1187
(207) 772-0974
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
680
NH
Other
Enumeration date
08/31/2009
Last updated
07/21/2022
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