Individual
YURIY USTINOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3 BAKER ST, RICHMOND, ME 04357-1387
(512) 659-2443
Mailing address
15 CHALLENGER DR, LEWISTON, ME 04240-1041
(207) 623-8411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1413
ME
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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