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General NPI Number Information
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NPI Number | 1366618993
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Entity Type | Organization
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Legal Business Name | YORK PSYCHOTHERAPY ASSOCIATES INC
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Dates
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Enumeration Date | 05/04/2008
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Last Update Date | 05/04/2008
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Provider Practice Location Address
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Address Line | 192 YORK ST
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City | YORK
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State | ME
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Zip | 03909-1021
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Country | US
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Telephone | 207-363-2164
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Fax | 207-363-7808
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Provider Business Mailing Address
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Address Line | 192 YORK ST
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City | YORK
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State | ME
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Zip | 03909-1021
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Country | US
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Telephone | 207-363-2164
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Fax | 207-363-7808
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CONSTANCE HANLEY
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Credential | PH.D
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Telephone | 207-363-2164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 00466
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License Number State | ME
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