Individual
AMANDA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, CCS
Contact information
Practice address
525 MAIN ST STE E, SOUTH PORTLAND, ME 04106-5457
(207) 767-0991
Mailing address
525 MAIN ST STE E, SOUTH PORTLAND, ME 04106-5457
(207) 767-0991
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC6619
ME
Other
Enumeration date
02/18/2022
Last updated
02/18/2022
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