Organization
OUTDOOR PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNMARIE MICA LAGEROOS PSYD (OWNER)
(207) 808-0428
Entity
Organization
Contact information
Practice address
205 OCEAN AVENUE, PORTLAND, ME 04103
(207) 808-0428
(207) 773-5512
Mailing address
31 GORHAM RD P.O. BOX 181, SCARBOROUGH, ME 04070
(207) 808-0428
(207) 773-5512
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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