Individual
MS. JUDITH EMILY BOUDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5 MARTIN STREET, PRESQUE ISLE, ME 04769-2238
(207) 941-8727
(207) 992-2784
Mailing address
21 MAIN STREET, SUITE 301, BANGOR, ME 04401-6359
(207) 941-8727
(207) 922-2784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6581
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257150099
—
ME
Enumeration date
11/12/2009
Last updated
11/12/2009
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