Provider Demographics
NPI:1851819841
Name:MUSTO, ANGELA MARIE (LADC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIE
Last Name:MUSTO
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04342-3643
Mailing Address - Country:US
Mailing Address - Phone:207-656-2171
Mailing Address - Fax:
Practice Address - Street 1:366 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:ME
Practice Address - Zip Code:04342-3643
Practice Address - Country:US
Practice Address - Phone:207-656-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC6274101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)