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Organization

MAINE GEROPSYCHOLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARTIN MORTHLAND PH.D. (OWNER)
(207) 721-8143
Entity
Organization

Contact information

Practice address
14 MAINE ST, SUITE 111-C, BRUNSWICK, ME 04011-2049
(207) 721-8143
(207) 721-8143
Mailing address
14 MAINE ST, SUITE 111-C, BRUNSWICK, ME 04011-2049
(207) 721-8143
(207) 721-8143

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PS1413
ME

Other

Enumeration date
10/21/2015
Last updated
11/04/2015
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