Doctor Name: | MICHAEL J DRISCOLL |
NPI Number: | 1144489634 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | LC1308 |
Business Practice Address: | 8 Pleasant Blvd Machias, ME - 04654 |
Business Phone Number: | 2072556366 |
Business Fax Number: | |
Mailing Address: | Po Box 555, CALAIS |
State: | ME |
Postal Code: | 046190555 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/09/2008 |
NPI Last Update Date: | 06/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LC1308 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |