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NPI Profile for THERESA KAVANAH in AUGUSTA, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Psychiatric/Mental Health |
163WP0808X |
| NPI Number | 1205293594 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/19/2016 | |
| Last updated | 01/19/2016 - About 10 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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THERESA KAVANAH
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THERESA KAVANAH