Individual
MRS. PHYLLIS JO WARCHOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
159 ALBION RD, WINDHAM, ME 04062-4504
(207) 892-4179
Mailing address
159 ALBION RD, WINDHAM, ME 04062-4504
(207) 892-4179
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC3941
ME
Other
Enumeration date
12/11/2009
Last updated
12/11/2009
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