Individual
TABETHA LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
14 WINTER ST, SANFORD, ME 04073-3322
(207) 324-4054
Mailing address
14 WINTER ST, SANFORD, ME 04073-3322
(207) 459-8331
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC7090
ME
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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