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Individual

JON MUENCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW,LADC

Contact information

Practice address
525 MAIN ST, SOUTH PORTLAND, ME 04106-5462
(207) 874-1045
(207) 767-0995
Mailing address
525 MAIN ST, SOUTH PORTLAND, ME 04106-5462
(207) 874-1045
(207) 767-0995

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC3383
ME
101Y00000X
Counselor
Primary
MC6625
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431946499
ME
Enumeration date
10/13/2009
Last updated
10/13/2009
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