| NPI | 1841985066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN M LONG Principal 207-292-2546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist, Clinical | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-04-05 |