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General NPI Number Information
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NPI Number | 1992870976
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Entity Type | Individual
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Provider Name | KIM ROSAN TOUSIGNANT PSY.D.,
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Gender | Female
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 151 MAIN STREET SUITE 2
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City | BUCKSPORT
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State | ME
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Zip | 04416
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Country | US
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Telephone | 207-460-7974
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Fax | 207-469-1932
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Provider Business Mailing Address
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Address Line | PO BOX 1694
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City | BUCKSPORT
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State | ME
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Zip | 04416-1694
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Country | US
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Telephone | 207-460-7974
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Fax | 207-469-1932
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS1257
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License Number State | ME
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