Individual
JOSEPH C FARESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
61 MAIN ST, BANGOR, ME 04401-6397
(207) 341-5844
Mailing address
42 WESSNETTE DR, HAMPDEN, ME 04444-3016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4605
ME
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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