Individual
TRAVIS J DOBOSZENSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-9141
Mailing address
1155 LISBON ST, LEWISTON, ME 04240-5025
(207) 783-9141
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC3758
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4408
ME
Other
Enumeration date
03/18/2009
Last updated
11/27/2012
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