Provider Demographics
NPI:1164242905
Name:VOTER, KATHLEEN L (MS, NCSP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:L
Last Name:VOTER
Suffix:
Gender:F
Credentials:MS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 SANFORD RD
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:ME
Mailing Address - Zip Code:04090-5534
Mailing Address - Country:US
Mailing Address - Phone:207-646-5953
Mailing Address - Fax:
Practice Address - Street 1:276 SANFORD RD
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:ME
Practice Address - Zip Code:04090-5534
Practice Address - Country:US
Practice Address - Phone:207-646-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool