Individual
SCOTT J DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
9 EVERETT ST, BRUNSWICK, ME 04011-2403
(207) 751-5429
Mailing address
PO BOX 871, BRUNSWICK, ME 04011-0871
(207) 751-5429
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS501
ME
103TC0700X
Clinical Psychologist
PSYCH000501
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003544
ANTHEM STAR #
ME
05
—
135350000
—
ME
01
—
5594271
AETNA
ME
Enumeration date
07/12/2006
Last updated
02/15/2020
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