Individual
LORA MICHELLE TOMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 CONGRESS ST, PORTLAND, ME 04102-1908
(207) 221-2292
Mailing address
2300 CONGRESS ST, PORTLAND, ME 04102-1908
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
LPN13473
ME
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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