Individual
DR. KENNETH A. BEATTIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
64 CHURCH ST, ELLSWORTH, ME 04605-1658
(207) 669-6011
(207) 669-6011
Mailing address
94 MILL ST, ORONO, ME 04473-4040
(207) 669-6011
(207) 669-6011
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1018
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336970000
—
ME
Enumeration date
07/26/2006
Last updated
07/09/2007
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