Provider Demographics
NPI:1467909168
Name:SANFORD, MAUREEN D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:D
Last Name:SANFORD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 US ROUTE 1 STE 2A
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-7006
Mailing Address - Country:US
Mailing Address - Phone:207-352-5011
Mailing Address - Fax:207-352-5013
Practice Address - Street 1:120 MAIN ST STE 126
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3527
Practice Address - Country:US
Practice Address - Phone:207-352-5011
Practice Address - Fax:207-352-5013
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-10
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1465103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist