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Contact Information

ANNIE DERTHICK, PHD
76 HIGH ST
LEWISTON, ME04240
 Phone: 207-795-2800
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

103TF0000X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ANNIE DERTHICK · (Female)

NPI # 1689039422
Status Active
Credentials PHD
Entity Individual
Enumeration date 12/21/2015
Last updated 09/13/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 107779
  • ME License # PS1563
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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