Provider Demographics
NPI:1003163841
Name:BUNCH, ALLISON E (LMFT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:BUNCH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 DAKOTA ROCK DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-6358
Mailing Address - Country:US
Mailing Address - Phone:941-592-8826
Mailing Address - Fax:
Practice Address - Street 1:101 AMERICAN CENTER PL
Practice Address - Street 2:SUITE 108
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4448
Practice Address - Country:US
Practice Address - Phone:813-951-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-11
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2710106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist