NPI Profile for KELLY L BUTLER in PORTLAND, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1699953885 |
|
| Status | Active | |
| Credentials | M.A., LCPC, LADC | |
| Entity | Individual | |
| Enumeration date | 02/10/2008 | |
| Last updated | 01/22/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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KELLY L BUTLER
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