Individual
MARISSA DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, CCS
Contact information
Practice address
9 SUNDERLAND RD, POLAND, ME 04274-7500
(207) 522-9608
Mailing address
9 SUNDERLAND RD, POLAND, ME 04274-7500
(207) 522-9608
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CCS8524
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC7702
ME
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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