Individual
DR. JUDSON D. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
62 ELM ST, PORTLAND, ME 04101-3091
(207) 553-7056
(207) 773-2082
Mailing address
29 FRANKLIN ST, BANGOR, ME 04401-4909
(207) 942-3816
(207) 561-4725
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS352
ME
103TC0700X
Clinical Psychologist
PS352
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098303
ANTHEM LEGACY NUMBER
ME
Enumeration date
01/25/2006
Last updated
10/03/2007
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