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Individual

ELLEN J POPENOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, MPH

Contact information

Practice address
1577 CONGRESS ST., 2ND FLOOR, PORTLAND, ME 04102-2169
(207) 662-1442
(207) 775-2467
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS557
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431921399
ME
Enumeration date
10/04/2006
Last updated
04/15/2011
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