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Individual

TIBBY YORK-LONGPRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
11 LISBON ST, SUITE 105, LEWISTON, ME 04240-7198
(207) 783-3574
Mailing address
11 LISBON ST, SUITE 105, LEWISTON, ME 04240-7198
(207) 783-3574

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC2470
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432018999
ME
Enumeration date
06/25/2008
Last updated
07/08/2008
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