Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PE721 | ME |
Y | 103TC0700X | Clinical Psychologist | PE721 | ME |
NPI | 1013081645 |
---|---|
Provider Name | Diane Loranger |
First Address | Saco, ME 04072-0331 |
Second Address | Biddeford, ME 04005-9415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 26/03/2008 |