Individual
JEANINE A. LEBLANC-GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1 STACKPOLE DR, MACHIAS, ME 04654-7000
(207) 255-0996
(207) 255-8748
Mailing address
1 STACKPOLE DR, MACHIAS, ME 04654-7000
(207) 255-0996
(207) 255-8748
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC 2539
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431773799
—
ME
Enumeration date
06/10/2006
Last updated
10/03/2013
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