Provider Demographics
NPI:1992037980
Name:TOLMAN, MATTHEW D (PSYD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:TOLMAN
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:P.O. BOX 422
Mailing Address - Street 2:ACADIA HOSPITAL CORP.
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-0422
Mailing Address - Country:US
Mailing Address - Phone:207-973-6100
Mailing Address - Fax:207-973-6109
Practice Address - Street 1:268 STILLWATER AVENUE
Practice Address - Street 2:ACADIA HOSPITAL CORP.
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-973-6100
Practice Address - Fax:207-973-6109
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
METP1291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical