Individual
EDWARD BURGESS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
1525 LISBON ST, LEWISTON, ME 04240-3515
(207) 241-7959
(207) 241-8318
Mailing address
1525 LISBON ST, LEWISTON, ME 04240-3515
(207) 241-7959
(207) 241-8318
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC5865
ME
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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