Individual
IAN COMPTON MACKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
61 COLBY AVE, OCEAN PARK, ME 04063
(207) 934-5450
Mailing address
123 ANDOVER RD, WESTBROOK, ME 04092-3850
(207) 661-6299
(207) 661-6322
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC3913
—
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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