Individual
MR. BRIAN MOYNIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
42 CEDAR ST, BANGOR, ME 04401-6433
(207) 947-0366
(207) 942-4350
Mailing address
PO BOX 425, BANGOR, ME 04402-0425
(207) 947-0366
(207) 942-4350
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC2733
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272730099
—
ME
Enumeration date
04/06/2007
Last updated
05/07/2012
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