Provider Demographics
NPI:1891058673
Name:MENDIOLA, ROLANDO BRYAN ABERIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:BRYAN ABERIN
Last Name:MENDIOLA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 FULLER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1739
Mailing Address - Country:US
Mailing Address - Phone:207-517-2390
Mailing Address - Fax:
Practice Address - Street 1:32 FULLER ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-1739
Practice Address - Country:US
Practice Address - Phone:207-517-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY 9306-PR103TC0700X
MEPS1495103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical