Individual
EMMANUEL NORMAN GIDEON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 WAINWRIGHT CIR E, SOUTH PORTLAND, ME 04106-2516
(207) 671-5054
Mailing address
15 WAINWRIGHT CIR E, SOUTH PORTLAND, ME 04106-2516
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
9957298
ME
103TB0200X
Cognitive & Behavioral Psychologist
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Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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