| NPI | 1174154041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MCKENNA Owner, Clinician 207-482-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-07-10 |