Individual
MRS. ROBERTA JACQUELINE MULLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
256 CRESSEY RD, MONMOUTH, ME 04259-6804
(207) 933-4092
Mailing address
256 CRESSEY RD, MONMOUTH, ME 04259-6804
(207) 933-4092
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC1420
ME
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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