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Individual

DR. ANN M CHRISTIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 773-7993
Mailing address
205 OCEAN AVE, PORTLAND, ME 04103-5712
(207) 773-7993

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1197
ME
103TC0700X
Clinical Psychologist
PSY002054
GA
103TC0700X
Clinical Psychologist
PY 5523
FL
103TS0200X
School Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000741584A
GA
01
10751280
CAQH
ME
01
200300
ANTHEM BC/BS
ME
05
432779400
ME
01
461740
VALUE OPTIONS
GA
01
582452807
FEDERAL TAX ID
GA
Enumeration date
04/12/2007
Last updated
07/21/2022
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