Tina W Bentley

Individual provider Active NPI Marriage & Family Therapist · Bucksport, ME

NPI 1992342240 · NPPES record last updated Dec 5, 2019

Key facts

NPI
1992342240
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
XM5276 (ME)
Practice address
148 Main St
Bucksport, ME 04416-4075
Phone
(207) 479-4066
NPI assigned
Dec 5, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
XM5276MEMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X XM5276 ME Yes

Addresses

Primary practice location

148 Main St
Bucksport, ME 04416-4075

Mailing address

PO Box 83
Sullivan, ME 04664-0083
Phone (207) 479-4066

Other providers in Bucksport, ME

All providers in Bucksport, ME · Marriage & Family Therapist in Maine

Sources for this page

Verify at the official NPI Registry.