Individual
STACEY A LAGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
300 PINE ST, LEWISTON, ME 04240-6309
(207) 777-3399
Mailing address
301 E HEBRON RD, TURNER, ME 04282-4514
(207) 225-5069
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC5044
ME
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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