Provider Demographics
NPI:1033592837
Name:ORR, RACHEL LAWSON (PSYD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LAWSON
Last Name:ORR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ASHLEY
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 SHAPE DR
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6601
Mailing Address - Country:US
Mailing Address - Phone:207-467-8966
Mailing Address - Fax:
Practice Address - Street 1:SOUTHERN MAINE HEALTH CARE PEDIATRICS
Practice Address - Street 2:3 SHAPE DRIVE
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043
Practice Address - Country:US
Practice Address - Phone:207-467-8930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
NH1369103TC0700X
MEPS1588103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist