Individual
MARY-ELLEN OSTHERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LADC CCS
Contact information
Practice address
17 MASONIC STREET, ROCKLAND, ME 04841
(207) 841-6775
(207) 236-8073
Mailing address
310 HOSMER POND RD, CAMDEN, ME 04843-4053
(207) 841-6775
(207) 236-8073
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC3421
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104000000
—
ME
Enumeration date
10/16/2006
Last updated
06/11/2008
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