| NPI | 1275645939 |
|---|---|
| Other Name | TIDESIDE |
| Entity Type | Organization |
| Authorized Contact | KENNETH A. BEATTIE Sole Owner 207-669-6011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ME ps1018) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |