Davis, Glen E

Davis, Glen E is an individual health care provider with primary practice located at 14 Stonewall Way , Falmouth ME 04105-2491. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Davis, Glen E can be contacted via phone (207) 221-2631.

Contact Information

Primary practice address
14 Stonewall Way Falmouth ME 04105-2491
Phone: (207) 221-2631
Fax: (866) 611-6717
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PS593 Maine
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS593 Maine

Profile Details

NPI number 1194767137
LBN Legal business name Davis, Glen E
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Feb 17th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194767137 NPPES
Maine MEDICAID 154420000

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