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Individual

DANIELLE YVONNE FAZIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, CADC

Contact information

Practice address
71 US ROUTE 1 STE E, SCARBOROUGH, ME 04074-7168
(207) 773-9931
(207) 879-5576
Mailing address
44 SPRUCE ST # 1, PORTLAND, ME 04102-3716
(207) 712-2291

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC6407
ME
1041C0700X
Clinical Social Worker
Primary
LC18182
ME

Other

Enumeration date
08/07/2017
Last updated
07/21/2022
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