Individual
MCKAYLA DIANE SOUCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRMA, DSP, CNA
Contact information
Practice address
168 MAIN ST, VAN BUREN, ME 04785-1238
(207) 868-4226
Mailing address
168 MAIN ST, VAN BUREN, ME 04785-1238
(207) 868-4226
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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