Individual
BRUCE A CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
253-255 HAMMOND ST., BANGOR, ME 04401
(207) 941-1612
(207) 941-1634
Mailing address
98 CUMBERLAND ST, BANGOR, ME 04401-5234
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCS4213
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC3827
ME
101YM0800X
Mental Health Counselor
LC12059
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433697199
—
ME
Enumeration date
08/06/2009
Last updated
08/06/2009
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