Individual
JANE VIRGINIA WILDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
400 WESTERN AVE, SOUTH PORTLAND, ME 04106-1704
(207) 774-7111
Mailing address
400 WESTERN AVE, SOUTH PORTLAND, ME 04106-1704
(207) 774-7111
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC8091
ME
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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