Individual
IMI GANZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
27 STATE ST, STE 54, BANGOR, ME 04401-5113
(207) 941-9311
(207) 941-9311
Mailing address
27 STATE ST, STE 54, BANGOR, ME 04401-5113
(207) 941-9311
(207) 941-9311
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS937
ME
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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