Individual
SUSANNAH F. RISTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
7 BLUE WAVE PROFESSIONAL CTR, KENNEBUNK, ME 04043-7049
(207) 985-3137
(207) 985-2640
Mailing address
7 BLUE WAVE PROFESSIONAL CTR, KENNEBUNK, ME 04043-7049
(207) 985-3137
(207) 985-2640
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS645
ME
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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