Individual
PETER GOODYEAR ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
23 STONE ST, AUGUSTA, ME 04330
(207) 622-3300
Mailing address
23 STONE ST, AUGUSTA, ME 04330
(207) 622-3300
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
396
ME
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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