NPI | 1366513897 |
---|---|
Entity Type | Organization |
Authorized Contact | GORDON POWELL STREET Business Manager 207-655-2737 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ME PS1177) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ME PS1176) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2020-08-22 |