| Doctor Name: | MIRIAM WOLFENSTEIN |
| NPI Number: | 1073884151 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PS1416 |
| Business Practice Address: | 62 Portland Rd 42 Kennebunk, ME - 040436650 |
| Business Phone Number: | 2072517147 |
| Business Fax Number: | 8888588495 |
| Mailing Address: | 50 Brown St, KENNEBUNK |
| State: | ME |
| Postal Code: | 040437242 |
| Phone Number: | 2074673115 |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2012 |
| NPI Last Update Date: | 09/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS1416 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |