| NPI | 1528784022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA GEORGETTE LIBBY Clinical Psychologist 207-200-3103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |