Individual
FARHANA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
174 S FREEPORT RD, 2E, FREEPORT, ME 04032
(207) 865-9225
(207) 865-9241
Mailing address
174 S FREEPORT RD 2E, FREEPORT, ME 04032
(207) 865-9225
(207) 865-9241
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P5954
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038264
ANTHEM
ME
Enumeration date
09/28/2006
Last updated
07/08/2007
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