Individual
DR. ROBERT L. GALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
77 JAMES ST, BANGOR, ME 04401-4661
(207) 942-3011
(207) 942-0350
Mailing address
77 JAMES ST, BANGOR, ME 04401-4661
(207) 942-3011
(207) 942-0350
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PS402
ME
103T00000X
Psychologist
Primary
PS402
ME
103TC0700X
Clinical Psychologist
PS402
ME
103TF0000X
Family Psychologist
PS402
ME
103TF0200X
Forensic Psychologist
PS402
ME
103TH0100X
Health Service Psychologist
PS402
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003418
ANTHEM
ME
01
—
2186061
AETNA
ME
05
—
222380000
—
ME
01
—
E002411
MARTINS POINT
ME
Enumeration date
12/12/2006
Last updated
12/22/2009
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