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Organization

MAINE CHILD PSYCHOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GLEN DAVIS PH.D. (PSYCHOLOGIST)
(207) 221-2631
Entity
Organization

Contact information

Practice address
14 STONEWALL WAY, FALMOUTH, ME 04105-2491
(207) 221-2631
(866) 611-6717
Mailing address
14 STONEWALL WAY, FALMOUTH, ME 04105-2491
(207) 221-2631
(866) 611-6717

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS593
ME

Other

Enumeration date
06/15/2012
Last updated
02/22/2022
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