McKayla Diane Soucy, CRMA, DSP, CNA
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Van Buren, ME. Individual provider (NPI-1).
NPI number1982244570
StatusActive
Last updated in NPPESJan 10, 2020
Details
- NPI
- 1982244570
- Entity type
- Individual (NPI-1)
- Name
- McKayla Diane Soucy
- Credential
- CRMA, DSP, CNA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 10, 2020
- Certification date
- Jan 10, 2020
- Last updated
- Jan 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
168 Main StVan Buren, ME 04785-1238
Phone 207-868-4226
Mailing address
168 Main StVan Buren, ME 04785-1238
Phone 207-868-4226
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