| Re/vision Enterprises, Inc. | |
|
5 Nason Court Suite 7 Kennebunk ME 04043-7051 | |
| (207) 985-3137 | |
| (207) 985-2640 |
| Full Name | Re/vision Enterprises, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5 Nason Court, Kennebunk, Maine |
| Authorized Official Name and Position | Susannah F. Ristine (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2079853137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Re/vision Enterprises, Inc. 5 Nason Court Suite 7 Kennebunk ME 04043 Ph: (207) 985-3137 | Re/vision Enterprises, Inc. 5 Nason Court Suite 7 Kennebunk ME 04043-7051 Ph: (207) 985-3137 |
| NPI Number | 1295969301 |
|---|---|
| Provider Enumeration Date | 05/05/2009 |
| Last Update Date | 05/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295969301 | NPI | - | NPPES |
| 114230100 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PS645 (Maine) | Primary |
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