Individual
DR. MACKENNA ANDERSON MURTAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
618 MAIN ST, LEWISTON, ME 04240-5935
(207) 795-6110
(207) 795-6189
Mailing address
618 MAIN ST, LEWISTON, ME 04240-5935
(207) 795-6110
(207) 795-6189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS2419
ME
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588785463
—
ME
Enumeration date
01/05/2019
Last updated
03/09/2022
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