Donna Mackenzie

Individual provider Active NPI Speech-Language Pathologist · Kittery, ME

NPI 1154636041 · NPPES record last updated Aug 16, 2010

Key facts

NPI
1154636041
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP1201 (ME)
Practice address
200 Rogers Rd
Kittery, ME 03904-1458
Phone
(207) 439-1331
Fax
(207) 439-5407
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP1201MEMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1201 ME Yes

Addresses

Primary practice location

200 Rogers Rd
Kittery, ME 03904-1458

Mailing address

200 Rogers Rd
Kittery, ME 03904-1458

Other providers in Kittery, ME

All providers in Kittery, ME · Speech-Language Pathologist in Maine

Sources for this page

Verify at the official NPI Registry.