PHOENIX R JETT

LEWISTON, ME
NPI1750026860
Former NameJULIE E THERIAULT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ME  CAC7863)
Enumeration Date2022-05-03
Last Update Date2024-08-07
Business Address
PHOENIX R JETT
18 MOLLISON WAY
LEWISTON, ME 04240-5811
Phone number: 207-312-6860
Mailing Address
PHOENIX R JETT
18 MOLLISON WAY
LEWISTON, ME 04240-5811
Phone number: 207-312-6860