Individual
TRENA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
18 MOLLISON WAY, LEWISTON, ME 04240-5811
(207) 312-6860
(207) 312-6863
Mailing address
309 CENTRAL AVE APT 2, LEWISTON, ME 04240-4620
(207) 713-3757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC8895
ME
Other
Enumeration date
04/19/2023
Last updated
10/07/2024
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