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Individual

MS. LAURA ANN BOUZAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASTER OF SOCIAL WOR

Contact information

Practice address
27 STATE ST, SUITE 66, BANGOR, ME 04401-5113
(207) 945-9343
Mailing address
27 STATE ST, SUITE 66, BANGOR, ME 04401-5113
(207) 945-9343

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC 295
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030236
ANTHEM BLUECROSS AND BLUE
ME
Enumeration date
01/25/2007
Last updated
07/08/2007
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