Individual
PETER JAMES IPPOLITI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4 UNION ST, SUITE 25, BANGOR, ME 04401
(207) 942-5656
Mailing address
4 UNION ST, SUITE 25, BANGOR, ME 04401
(207) 942-5656
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS917
ME
Other
Enumeration date
03/31/2008
Last updated
05/05/2008
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