Individual
MS. GEORGIA GALE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
4 CENTRAL AVE, LIMERICK, ME 04048-0091
(207) 793-4933
(207) 793-4909
Mailing address
279 MITCHELL RD, CAPE ELIZABETH, ME 04107
(207) 899-1285
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
ME
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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