Individual
LYLE VINTINNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
53 BAXTER BLVD STE 3, PORTLAND, ME 04101-1827
(413) 356-5423
Mailing address
12 1ST ST STE 2, TOPSHAM, ME 04086-1334
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1866
ME
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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