MEDICARE: DR. ANNA ENG PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810007457	VA
2	103TC0700X	Clinical Psychologist	PS2736	ME

General Provider Information

NPI Number	:	1407176951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA ENG PSYD

Provider Business Mailing Address
First Line	:	126 VERANDA ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-5523
Country	:	US
Telephone Number	:	207-200-8886
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 VERANDA ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-5523
Country	:	US
Telephone Number	:	207-200-8886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2010
Last Update Date	:	05/20/2026

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