| NPI | 1073343729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH G MALENFANT Psychiatric Nurse Practitioner 207-756-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |