Individual
AMY-JO FAIRBROTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
12 ACME RD STE 207, BREWER, ME 04412-1546
(207) 573-4722
Mailing address
12 ACME RD STE 207, BREWER, ME 04412-1546
(207) 573-4722
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC6397
ME
Other
Enumeration date
02/13/2019
Last updated
10/20/2020
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