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LARISSA ARAXE MEAD-WESCOTT PHD

Clinical Neuropsychologist

Bangor, Maine

Provider NPI: 1417922725

Provider Information:
 LARISSA ARAXE MEAD-WESCOTT PHD
Gender: F
Not Sole Proprietor

Practice Location:
277 STATE ST SUITE 2A BANGOR, ME 04401 US
Tel: 207-990-2580  Fax: 207-990-1930

Business Mailing Address:
277 STATE ST SUITE 2A BANGOR, ME 04401 US
Tel: 207-990-2580  Fax: 207-990-1930

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MEPS960

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM03689501
AETNA306940101
330640099ME05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS ME - Page 1



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