Individual
MR. ISAAC SHAINBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 PARK ST, LEWISTON, ME 04240-7172
(207) 449-7680
Mailing address
65 COLLEGE ST, LEWISTON, ME 04240-6807
(207) 449-7680
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC5601
ME
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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