Provider Demographics
NPI:1053667634
Name:VECCHIO, JULIE WYONA (CADC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:WYONA
Last Name:VECCHIO
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:WYONA
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:74 MAY ST # 1
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2948
Mailing Address - Country:US
Mailing Address - Phone:207-782-3386
Mailing Address - Fax:
Practice Address - Street 1:369 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7030
Practice Address - Country:US
Practice Address - Phone:207-782-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC5190101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)