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NPI Code Detail

MEDICARE: MARYBETH ONKTUSH CADC

MEDICARE:   MARYBETH  ONKTUSH  CADC
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) CounselorCAC5561ME

General Provider Information

NPI Number : 1811401227
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYBETH ONKTUSH CADC
Provider Business Mailing Address
First Line : 24 GEORGE ST
Second Line :
City : ALFRED
State : ME
Zip : 04002-3296
Country : US
Telephone Number : 207-324-1137
Fax Number : 207-324-5290
Provider Business Practice Location Address
First Line : 105 GARLAND RD
Second Line :
City : WEST NEWFIELD
State : ME
Zip : 04095-3527
Country : US
Telephone Number : 207-324-1137
Fax Number : 207-324-5290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 11/21/2017

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Directions to “ MARYBETH ONKTUSH CADC” Practice Location

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