Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013044429 |
---|---|
Provider Name | Dr. Catherine Carney Brodeur |
First Address | Eliot, ME 03903-2000 |
Second Address | Sanford, ME 04073-2552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/04/2009 |