Individual
SHANDI LYNN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 CALDWELL RD, AUGUSTA, ME 04330-5735
(207) 626-3448
Mailing address
22 NORTH ST APT 3, AUGUSTA, ME 04330-5009
(207) 458-2356
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC8759
ME
Other
Enumeration date
02/08/2025
Last updated
02/08/2025
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