Individual
KEVIN WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
525 MAIN ST, SOUTH PORTLAND, ME 04106-5457
(207) 874-1045
(207) 767-0995
Mailing address
525 MAIN ST, SOUTH PORTLAND, ME 04106-5457
(207) 874-1045
(207) 767-0995
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CAD4481
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164484093
—
ME
Enumeration date
03/07/2013
Last updated
03/07/2013
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