Individual
MS. PATRICIA ANN CHAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LADC 1
Contact information
Practice address
20 FORSYTHE AVE, S YARMOUTH, MA 02664-1814
(508) 398-5155
(508) 398-3478
Mailing address
116 BROOK RD, PLYMOUTH, MA 02360-6330
(508) 224-5668
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4936 , 269
MA
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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