=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043494271
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCES O'HARE LADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2007
-----------------------------------------------------
Last Update Date | 12/24/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 582 MAIN STREET
-----------------------------------------------------
City | LIMESTONE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-325-4727
-----------------------------------------------------
Fax | 207-325-4727
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 582 MAIN STREET PO BOX 501
-----------------------------------------------------
City | LIMESTONE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-325-4727
-----------------------------------------------------
Fax | 207-325-4727
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | LC4169
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------