Individual
MS. KAITLIN ROSE STALLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
100 CAMPUS AVE STE A&B, LEWISTON, ME 04240-6040
(207) 755-3434
(207) 755-3474
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC4708
ME
101YP2500X
Professional Counselor
XL4268
ME
Other
Enumeration date
12/05/2013
Last updated
01/21/2022
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