is a Psychiatric/mental Health in Bangor, Maine. practices all healthcare services and medical treatments related to Psychiatric/mental Health. The NPI Number for is 1215988852. The last update date is .
's current location address is 263 State St, Bangor, Maine. You can contact this provider via phone number 2079453615 and fax number 2079453444. The mailing address for is 263 State St, Bangor, Maine. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 263 State St, Bangor, Maine |
| Phone Number | 2079453615 |
| Fax Number | 2079453444 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1215988852 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 263 State St |
|---|---|
| City | Bangor |
| State | Maine (ME) |
| Post Code | 440154350 |
| Phone Number | 2079453615 |
| Fax Number | 2079453444 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatric/mental Health |
|---|---|
| Taxonomy | 363Lp0808X |
| Licence No | R037051 |
|
Definition: An advanced practice registered nurse expert in providing psychiatric and mental healthcare services. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 255830000 | ME | -- | |
| 48586 | ME | ANTHEM |
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