Individual
MARK RAINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
135 BRIDGE STREET, WEST FARMINGTON, ME 04992-0302
(207) 778-5437
Mailing address
PO BOX 302, WEST FARMINGTON, ME 04992-0302
(207) 778-5437
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS959
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100148
ANTHEM BCBS
ME
05
—
321170000
—
ME
Enumeration date
08/29/2007
Last updated
08/29/2007
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