Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS813 | ME |
Y | 103T00000X | Psychologist | PS813 | ME |
NPI | 1003854191 |
---|---|
Provider Name | Pamela Langelier |
First Address | Ocean Park, ME 04063-7560 |
Second Address | Saco, ME 04072-3509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 26/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100118 | BC/BS (01) | |
431585600 | (05) | ME |