Healthcare Provider Details

I. General information

NPI: 1568670826
Provider Name (Legal Business Name): RODNEY ALAN NADEAU PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 SMITHWOOD DR
NORTH YARMOUTH ME
04097-6525
US

IV. Provider business mailing address

65 SMITHWOOD DR
NORTH YARMOUTH ME
04097-6525
US

V. Phone/Fax

Practice location:
  • Phone: 207-829-5280
  • Fax:
Mailing address:
  • Phone: 207-829-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLSX9139
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: