Individual
EDWIN I VAN BIBBER-ORR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC-C
Contact information
Practice address
967 BROADWAY STE 2, SOUTH PORTLAND, ME 04106-4263
(802) 349-3909
Mailing address
89 ANDERSON ST UNIT 406, PORTLAND, ME 04101-6804
(802) 349-3909
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL6833
ME
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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