Individual
MAXINE WOLPH-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 COMMON ST, WATERVILLE, ME 04901-6678
(207) 696-4225
(207) 696-4211
Mailing address
PO BOX 288, ANSON, ME 04911-0288
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC122
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431821099
—
ME
Enumeration date
02/14/2009
Last updated
02/14/2009
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