| Organization Name: | GARY RASMUSSEN, PH.D. CLINICAL PSYCHOLOGIST PA |
| NPI Number: | 1962553065 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY G. RASMUSSEN (PRESIDENT) |
| Mailing Address: | 179 Main St Ste 208 Waterville |
| State: | ME US |
| Postal Code: | 049016672 |
| Phone Number: | 2078725003 |
| Fax Number: | 2078729445 |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 03/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 491 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |