Healthcare Provider Details

I. General information

NPI: 1194819482
Provider Name (Legal Business Name): RAMONA MARIE PANICI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 THUNDER RD
NORTH YARMOUTH ME
04097-6100
US

IV. Provider business mailing address

27 THUNDER RD
NORTH YARMOUTH ME
04097-6100
US

V. Phone/Fax

Practice location:
  • Phone: 207-829-2152
  • Fax:
Mailing address:
  • Phone: 207-829-2152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS1129
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: