Individual
KIMBERLY LATHE-MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
582 NASH RD, PITTSTON, ME 04345-5735
(207) 582-0205
Mailing address
582 NASH RD, PITTSTON, ME 04345-5735
(207) 582-0205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC5932
ME
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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