Individual
MS. ELIZABETH A BUNTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
136 CLARK ST # 1, PORTLAND, ME 04102-3804
(207) 266-6165
Mailing address
136 CLARK ST # 1, PORTLAND, ME 04102-3804
(207) 266-6165
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL4135
ME
Other
Enumeration date
05/10/2013
Last updated
05/10/2013
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