Provider Demographics
NPI:1629796453
Name:MACAULAY, REBECCA (PHD)
Entity Type:Individual
Prefix:PROF
First Name:REBECCA
Middle Name:
Last Name:MACAULAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WILLIAMS HALL
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04469-0001
Mailing Address - Country:US
Mailing Address - Phone:207-581-2044
Mailing Address - Fax:
Practice Address - Street 1:301 WILLIAMS HALL
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04469-0001
Practice Address - Country:US
Practice Address - Phone:207-581-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1564103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical