Individual
DIANE ELIZABETH MACKAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASS TEACHER CERTIFI
Contact information
Practice address
1115 WEST CHESTNUT ST, BROCKTON, MA 02301
(508) 559-0473
(508) 427-5361
Mailing address
115 CENTER ST, RAYNHAM, MA 02767
(508) 977-0766
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
12/27/2006
Last updated
07/08/2007
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