MEDICARE: DR. MONIQUE RICHARD KAHN PSY.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
1	103T00000X	Psychologist	PS1005	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	047300	OTHER	ME	ANTHEM BLUE CROSS BL SHLD

General Provider Information

NPI Number	:	1689769994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONIQUE RICHARD KAHN PSY.D.

Provider Business Mailing Address
First Line	:	108 MAIN RD S
Second Line	:
City	:	HAMPDEN
State	:	ME
Zip	:	04444-1204
Country	:	US
Telephone Number	:	207-862-2899
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 MAIN RD S
Second Line	:
City	:	HAMPDEN
State	:	ME
Zip	:	04444-1204
Country	:	US
Telephone Number	:	207-862-2899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	04/21/2008

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