Individual
MARTINA BLAKE GILMORE WING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
689 ODLIN RD STE 1, BANGOR, ME 04401-6709
(207) 945-7765
Mailing address
6 FLINT LN, VEAZIE, ME 04401-7131
(207) 708-0389
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC8156
ME
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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