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:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | ME | PS960 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AETNA | 3069401 | 01 | |
ANTHEM | 036895 | 01 | |
330640099 | ME | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin