Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 347 | ME |
Y | 103TC0700X | Clinical Psychologist | 347 | ME |
NPI | 1013122175 |
---|---|
Provider Name | Dr. Nicholas J Rehagen |
First Address | Livermore Falls, ME 04254-4020 |
Second Address | Livermore Falls, ME 04254-1330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |