Individual
TINA W BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
148 MAIN ST, BUCKSPORT, ME 04416-4075
(207) 479-4066
Mailing address
PO BOX 83, SULLIVAN, ME 04664-0083
(207) 479-4066
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
XM5276
ME
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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