Healthcare Provider Details

I. General information

NPI: 1558410894
Provider Name (Legal Business Name): DEBORA D. WARING PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 NORTHPORT AVE
BELFAST ME
04915-6006
US

IV. Provider business mailing address

253 NORTHPORT AVE
BELFAST ME
04915-6006
US

V. Phone/Fax

Practice location:
  • Phone: 207-338-4514
  • Fax: 207-338-4533
Mailing address:
  • Phone: 207-338-4514
  • Fax: 207-338-4533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS1077
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: