Provider Demographics
NPI:1740445444
Name:FINK, ALAN M (PHD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:M
Last Name:FINK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 WILDWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2236
Mailing Address - Country:US
Mailing Address - Phone:207-282-4611
Mailing Address - Fax:
Practice Address - Street 1:6 WELLSPRING ROAD
Practice Address - Street 2:SUITE 4
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2447
Practice Address - Country:US
Practice Address - Phone:207-282-4611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS397103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME214760000Medicaid