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Student Organized Health Care Education/Training Program

Provider NPI: 1598059131

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
322 MAIN ST  BAR HARBOR, ME 04609-1648 US
Tel: 315-719-5778  Fax: --

Business Mailing Address:
Tel: --  Fax: --

NPI Information:
NPI: 1598059131
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Organized Health Care Education/Training Program
Psychiatry & Neurology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2084P0800X





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