Individual
ALICIA MARIE ANTIUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, MHRT/C
Contact information
Practice address
2323 MEDWAY RD, MEDWAY, ME 04460-3106
(207) 249-0840
Mailing address
3 MAIN ST, EAST MILLINOCKET, ME 04430-1220
(207) 249-0840
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC8637
ME
171M00000X
Case Manager/Care Coordinator
35230
ME
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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