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General NPI Number Information
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NPI Number | 1063860229
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Entity Type | Organization
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Legal Business Name | JULIE L. QUIMBY, PHD
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Dates
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Enumeration Date | 05/28/2016
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Last Update Date | 05/28/2016
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Provider Practice Location Address
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Address Line | 14 MAINE ST SUITE 216B
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City | BRUNSWICK
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State | ME
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Zip | 04011-2049
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Country | US
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Telephone | 860-794-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MAINE ST SUITE 216B
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City | BRUNSWICK
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State | ME
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Zip | 04011-2049
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Country | US
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Telephone | 860-794-6850
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | KAITLIN H WHITE
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Credential | PHD
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Telephone | 860-794-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | PS1472
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License Number State | ME
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