Healthcare Provider Details

I. General information

NPI: 1316017361
Provider Name (Legal Business Name): JAMES MICHAEL FOLEY D.ED.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 05/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 WATERBORO RD
ALFRED ME
04002-3243
US

IV. Provider business mailing address

12 WATERBORO RD
ALFRED ME
04002-3243
US

V. Phone/Fax

Practice location:
  • Phone: 207-929-3663
  • Fax:
Mailing address:
  • Phone: 207-929-3663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0411
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: