Individual
KENDRA MICHELLE MCCALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC, MHRT/C, CRMA
Contact information
Practice address
420 CUMBERLAND AVE, PORTLAND, ME 04101-2823
(207) 523-4129
Mailing address
10 CARRIER WOOD RD APT 59, SCARBOROUGH, ME 04074-7188
(207) 239-1160
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC7137
ME
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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