Healthcare Provider Details

I. General information

NPI: 1043274988
Provider Name (Legal Business Name): RICHARD BOYD RAU PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 COUNTY RD
TURNER ME
04282-4208
US

IV. Provider business mailing address

395 COUNTY RD
TURNER ME
04282-4208
US

V. Phone/Fax

Practice location:
  • Phone: 207-577-4643
  • Fax:
Mailing address:
  • Phone: 207-577-4643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS494
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: