Individual
MS. JESSICA MEGAN BASALDUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
75 CENTRAL AVE, LEWISTON, ME 04240-6031
(207) 795-4180
(207) 753-6419
Mailing address
101 EAST AVE, LEWISTON, ME 04240-5662
(207) 777-3399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC6933
ME
104100000X
Social Worker
Primary
MC20649
ME
Other
Enumeration date
01/02/2020
Last updated
03/09/2022
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