Individual
MS. LAURIE MATSON FEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
918 BROADWAY, SOUTH PORTLAND, ME 04106-4329
(434) 960-7769
Mailing address
138 RIDGELAND AVE, SOUTH PORTLAND, ME 04106-4130
(434) 960-7769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC6240
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC6757
ME
Other
Enumeration date
10/23/2017
Last updated
02/05/2020
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