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NPI Code Detail

MEDICARE: DR. KAREN WESTERMAN PH.D

MEDICARE: DR. KAREN WESTERMAN PH.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPS0619ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003004OTHERMEANTHEM

General Provider Information

NPI Number : 1104952563
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAREN WESTERMAN PH.D
Provider Business Mailing Address
First Line : 17 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3914
Country : US
Telephone Number : 207-774-6486
Fax Number :
Provider Business Practice Location Address
First Line : 17 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3914
Country : US
Telephone Number : 207-774-6486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/09/2007

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