Individual
LARISSA ARAXE MEAD-WESCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
277 STATE ST, SUITE 2A, BANGOR, ME 04401-5439
(207) 990-2580
(207) 990-1930
Mailing address
277 STATE ST, SUITE 2A, BANGOR, ME 04401-5439
(207) 990-2580
(207) 990-1930
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS960
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036895
ANTHEM
—
01
—
3069401
AETNA
—
05
—
330640099
—
ME
Enumeration date
02/21/2006
Last updated
11/24/2010
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