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Individual

LINDSEY DEROSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
217 MAIN ST STE 202, LEWISTON, ME 04240-8193
(207) 618-5157
Mailing address
217 MAIN ST STE 202, LEWISTON, ME 04240-8193

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC6918
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
464126690
ME
Enumeration date
03/09/2020
Last updated
03/09/2020
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