| Beacon Light Neuropsychology, Llc | |
|
22 Free St Ste 404 Portland ME 04101-3900 | |
| (207) 544-6810 | |
| (207) 544-6888 |
| Full Name | Beacon Light Neuropsychology, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 22 Free St Ste 404, Portland, Maine |
| Authorized Official Name and Position | Craig Digiovanni (OWNER) |
| Authorized Official Contact | 8609658054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Light Neuropsychology, Llc 22 Free St Ste 404 Portland ME 04101-3900 Ph: (207) 544-6810 | Beacon Light Neuropsychology, Llc 22 Free St Ste 404 Portland ME 04101-3900 Ph: (207) 544-6810 |
| NPI Number | 1730902891 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730902891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
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