Goller, Anita Laurette

Goller, Anita Laurette is an individual health care provider with primary practice located at 6 Cumberland St , Brunswick ME 04011-1904. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Goller, Anita Laurette can be contacted via phone (207) 729-3092.

Contact Information

Primary practice address
6 Cumberland St Brunswick ME 04011-1904
Phone: (207) 729-3092
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS904 Maine

Profile Details

NPI number 1053391367
LBN Legal business name Goller, Anita Laurette
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Oct 24th, 2018 - about 7 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 1053391367 NPPES
Maine MEDICAID 209210000
Maine Other 038660
Maine Other 7160216

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