Individual
RYAN KIZITAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADC-A
Contact information
Practice address
12 BEECH ST, CALAIS, ME 04619-1203
(207) 454-1300
Mailing address
12 BEECH ST, CALAIS, ME 04619-1203
(207) 454-1300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AD6912
ME
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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