Individual
SHYANN NICOLE COLAVECCHIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
689 ODLIN RD STE 1, BANGOR, ME 04401-6709
(207) 945-7765
Mailing address
381 GRIFFIN RD, LEVANT, ME 04456-4505
(207) 659-9675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC8860
ME
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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