Foreside Behavior Associates
Psychologist, Clinical in Portland, ME. Organization (NPI-2).
NPI number1982076485
StatusActive
Last updated in NPPESNov 23, 2022
Details
- NPI
- 1982076485
- Entity type
- Organization (NPI-2)
- Legal business name
- Foreside Behavior Associates
- Organization subpart
- No
- Enumeration date
- Oct 22, 2015
- Certification date
- Nov 23, 2022
- Last updated
- Nov 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – |
Practice location
1321 Washington Ave Ste 302Portland, ME 04103-3675
Phone 207-613-7324 · Fax 207-613-7333
Mailing address
1321 Washington Ave Ste 302Portland, ME 04103-3675
Phone 207-613-7324 · Fax 207-613-7333
Authorized official
Susan Jarmuz-Smith
Clinical Director
2076137324
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