Individual
KENNETH OSCAR TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 WESTERN AVE, SOUTH PORTLAND, ME 04106-1704
(120) 777-4711
Mailing address
496 BUXTON RD, SACO, ME 04072-9511
(207) 286-5489
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AD7993
ME
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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