Individual
DR. JERRY SAPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 773-7993
Mailing address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 773-7993
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS901
ME
103TC0700X
Clinical Psychologist
PS901
ME
Other
Enumeration date
05/06/2011
Last updated
05/06/2011
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