Provider Demographics
NPI:1255445359
Name:OREM-HOUGH, CAROLE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:
Last Name:OREM-HOUGH
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 1:837 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2708
Mailing Address - Country:US
Mailing Address - Phone:207-775-0600
Mailing Address - Fax:207-799-0852
Practice Address - Street 1:837 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2708
Practice Address - Country:US
Practice Address - Phone:207-775-0600
Practice Address - Fax:207-799-0852
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1136103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist