Individual
TERESA LYNN MALLWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCPC, CAAD
Contact information
Practice address
622 PARKER HEAD RD, PHIPPSBURG, ME 04562-4586
(231) 534-5505
Mailing address
622 PARKER HEAD RD, PHIPPSBURG, ME 04562-4586
(231) 534-5505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401008704
MI
101YP2500X
Professional Counselor
Primary
CC4833
ME
Other
Enumeration date
02/14/2007
Last updated
04/03/2025
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