Individual
DR. GREGORY CARBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
491 STEVENS AVE, PORTLAND, ME 04103-2636
(207) 828-4026
(207) 773-4472
Mailing address
491 STEVENS AVE, PORTLAND, ME 04103-2636
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS499
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
314040099
—
ME
Enumeration date
05/14/2008
Last updated
05/14/2008
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