Individual
TINA L ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
16 COMMON ST, WATERVILLE, ME 04901-6611
(207) 872-7272
Mailing address
8 RUSSELL ST, WATERVILLE, ME 04901-5242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC5007
ME
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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