Individual
MS. ROREE CARTER SEVERANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
194 MAIN STREET, ELLSWORTH, ME 04605
(207) 812-2133
Mailing address
73 BUNKER DR, OTIS, ME 04605-7619
(207) 812-2133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4384
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431962399
—
ME
Enumeration date
03/25/2009
Last updated
07/23/2013
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