Provider Demographics
NPI:1619968682
Name:BATTERMAN, JENNIFER MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:BATTERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 COMMERCIAL ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4243
Mailing Address - Country:US
Mailing Address - Phone:207-390-0533
Mailing Address - Fax:888-920-6425
Practice Address - Street 1:825 COMMERCIAL ST UNIT 1
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4243
Practice Address - Country:US
Practice Address - Phone:207-390-0533
Practice Address - Fax:888-920-6425
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012518-1103TC0700X, 103TC2200X
MEPS1262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent