Doctor Name: | DR. NANCY ELLEN ROBERTS |
NPI Number: | 1154469617 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D., PH.D. |
License Number: | PS882 |
Business Practice Address: | 5 School St Ellsworth, ME - 046051932 |
Business Phone Number: | 2078527656 |
Business Fax Number: | |
Mailing Address: | Po Box 693, HOLDEN |
State: | ME |
Postal Code: | 044290693 |
Phone Number: | 2078527656 |
Fax Number: | |
NPI Enumeration Date: | 02/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS882 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |