Individual
CALEB ANDREW MAILLOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC-SUPERVISEE
Contact information
Practice address
3208 HERSHBERGER RD NW, ROANOKE, VA 24017-1842
(540) 202-2408
Mailing address
3208 HERSHBERGER RD NW, ROANOKE, VA 24017-1842
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0709026428
VA
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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