| NPI | 1831964154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN L CHASE Psychiatric Nurse Practitioner 207-419-9221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2024-01-05 |