Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 584 | ME |
Y | 103T00000X | Psychologist | 584 | ME |
NPI | 1013021187 |
---|---|
Provider Name | Dr. Beth A Bohnet |
First Address | Bangor, ME 04401-5309 |
Second Address | Bangor, ME 04401-5309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 22/01/2013 |