Individual
JESSICA MARIE PETRYCKI DALESSIO
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
Mailing address
659 HOGAN RD, BANGOR, ME 04401-3626
(207) 973-0400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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