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Individual

MIKEL KOMLA AVOKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
100 CAMPUS AVE STE A&B, LEWISTON, ME 04240-6040
(207) 755-3434
(207) 755-3474
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ME
101YM0800X
Mental Health Counselor
ME
104100000X
Social Worker
Primary
MC15022
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568779593
ME
Enumeration date
09/13/2010
Last updated
03/24/2020
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