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Individual

DARRELL FRAIZE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5 HOYTS RIDGE RD, BRIDGTON, ME 04009-1239
(207) 647-5629
Mailing address
5 HOYTS RIDGE RD, BRIDGTON, ME 04009-1239

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC3515
ME
101YP2500X
Professional Counselor
Primary
CC3575
ME

Other

Enumeration date
01/13/2014
Last updated
01/13/2014
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