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Behavioral Health & Social Service Providers Psychologist

Provider NPI: 1316972565

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 207-333-3308  Fax: 207-333-3309

Business Mailing Address:
Tel: 207-333-3308  Fax: 207-333-3309

NPI Information:
NPI: 1316972565
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
N103TB0200XBehavioral Health & Social Service Providers
N103TH0004XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 103T00000X





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