Mark Gregory Kiefner, PhD
Clinical Neuropsychologist in Portland, ME. Individual provider (NPI-1).
NPI number1346457017
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1346457017
- Entity type
- Individual (NPI-1)
- Name
- Mark Gregory Kiefner
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 16, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PS815 | ME | Yes |
Practice location
26 Portland StreetPortland, ME 04101
Phone 207-761-8402 · Fax 207-761-8405
Mailing address
Po Box 8600Portland, ME 04104
Phone 207-774-6323 · Fax 207-761-8460
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