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NPI Code Detail

MEDICARE: SARA DAWN CAMOLLI LADC

MEDICARE:   SARA DAWN CAMOLLI  LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLC5197ME

General Provider Information

NPI Number : 1952611881
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA DAWN CAMOLLI LADC
Provider Business Mailing Address
First Line : 95 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7282
Country : US
Telephone Number : 207-344-7271
Fax Number :
Provider Business Practice Location Address
First Line : 95 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7282
Country : US
Telephone Number : 207-344-7271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2010
Last Update Date : 03/06/2018

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Directions to “ SARA DAWN CAMOLLI LADC” Practice Location

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