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Individual

KATHLEEN BENDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
11 NORTH ST APT 2, PORTLAND, ME 04101-2771
(207) 828-1785
Mailing address
11 NORTH ST APT 2, PORTLAND, ME 04101-2771
(207) 828-1785

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6875
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286690099
ME
01
RB9
ANTHEM
ME
Enumeration date
11/16/2006
Last updated
02/02/2010
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