| NPI | 1831911361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN NOEL Owner 207-910-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-03-03 |