Individual
JOHN R LORENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
82 COLUMBIA ST STE 301, BANGOR, ME 04401-6357
(207) 942-8200
(207) 990-3065
Mailing address
82 COLUMBIA ST STE 301, BANGOR, ME 04401-6357
(207) 942-8200
(207) 990-3065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS0000444
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003591
ANTHEM PIN
ME
Enumeration date
05/15/2007
Last updated
07/07/2010
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