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Individual

MS. LISA DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC, CCS

Contact information

Practice address
659 HOGAN RD, BANGOR, ME 04401-3626
(207) 973-0400
(207) 973-1881
Mailing address
659 HOGAN RD, BANGOR, ME 04401-3626
(207) 973-0400
(207) 973-1881

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LD4779
ME

Other

Enumeration date
10/01/2019
Last updated
10/01/2019
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