Doctor Name: | ANDREA JAHNA |
NPI Number: | 1255650172 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | CAC4187 |
Business Practice Address: | 32 N High St Bridgton, ME - 040091125 |
Business Phone Number: | 2076475629 |
Business Fax Number: | |
Mailing Address: | 32 N High St, BRIDGTON |
State: | ME |
Postal Code: | 040091125 |
Phone Number: | 2076475629 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2010 |
NPI Last Update Date: | 05/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CAC4187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |