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General NPI Number Information
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NPI Number | 1912226754
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Entity Type | Organization
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Legal Business Name | MOLLY DELANEY, PSYD, INC
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 33 WHITE OAK RIDGE RD
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-4257
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Country | US
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Telephone | 207-563-8522
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Fax |
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Provider Business Mailing Address
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Address Line | 33 WHITE OAK RIDGE RD
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City | DAMARISCOTTA
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State | ME
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Zip | 04543-4257
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Country | US
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Telephone | 207-563-8522
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOLLY E DELANEY
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Credential | PSYD
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Telephone | 207-563-8522
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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 | PS1075
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License Number State | ME
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