Individual
DR. POLLY MOUTEVELIS-BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMFT
Contact information
Practice address
106 PINE ST, BANGOR, ME 04401-5294
(207) 990-5070
(207) 581-3017
Mailing address
PO BOX 2354, BANGOR, ME 04402-2354
(207) 990-5070
(207) 581-3017
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC284
ME
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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