Individual
MR. RIVER JOSHUA-DAVID BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
105 MIDDLE ST # 3, LEWISTON, ME 04240-7037
(207) 440-7922
Mailing address
77 OAK ST, LEWISTON, ME 04240-7108
(207) 509-0000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC6990
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CAC6990
C ADC
ME
Enumeration date
10/08/2019
Last updated
10/08/2019
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