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Individual

MRS. KIMBERLY S. GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CADC

Contact information

Practice address
276 MAIN ST, LEWISTON, ME 04240-7024
(207) 782-3386
Mailing address
3 FOREST CIR # 2, PORTLAND, ME 04103-1124
(207) 797-8389

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC4995
ME

Other

Enumeration date
11/01/2011
Last updated
11/01/2011
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