Individual
DR. BRUCE L. LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
53 S MAIN ST, SUITE 302, HANOVER, NH 03755-2022
(603) 676-7711
(603) 676-7711
Mailing address
53 S MAIN ST, PO BOX 957, HANOVER, NH 03755-2022
(603) 676-7711
(603) 676-7711
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
421
NH
103TC0700X
Clinical Psychologist
Primary
48-618
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30420051
—
NH
05
—
OVN0954
—
VT
Enumeration date
03/27/2007
Last updated
10/29/2008
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