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Individual

AMANDA MARIE PLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
499 STEVENS AVE, PORTLAND, ME 04103-2678
(207) 756-4232
Mailing address
541 BRIGHTON AVE # A, PORTLAND, ME 04102-2349
(207) 756-4232

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC6519
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC7416
ME

Other

Enumeration date
09/20/2019
Last updated
11/23/2021
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