Provider Demographics
NPI:1770118986
Name:WOZICH, KATRINA CLARE (CADC)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:CLARE
Last Name:WOZICH
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 FOYE RD
Mailing Address - Street 2:
Mailing Address - City:WISCASSET
Mailing Address - State:ME
Mailing Address - Zip Code:04578-4262
Mailing Address - Country:US
Mailing Address - Phone:207-440-1412
Mailing Address - Fax:
Practice Address - Street 1:91 CAMDEN ST STE 213
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2459
Practice Address - Country:US
Practice Address - Phone:207-806-0257
Practice Address - Fax:207-806-0257
Is Sole Proprietor?:No
Enumeration Date:2020-03-08
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC6356101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)