Organization
MICHAEL W MACKIE PHD A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WILLIAM VINCENT MACKIE JR. PHD (OWNER PROVIDER)
(424) 465-2840
Entity
Organization
Contact information
Practice address
10700 SANTA MONICA BLVD STE 300, LOS ANGELES, CA 90025-6587
(424) 465-2840
Mailing address
10700 SANTA MONICA BLVD STE 300, LOS ANGELES, CA 90025-6587
(424) 465-2840
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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