Provider Demographics
NPI:1083621346
Name:SAUNDERS, BRUCE THOMAS (PHD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:THOMAS
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 MOUNT HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4210
Mailing Address - Country:US
Mailing Address - Phone:207-947-4928
Mailing Address - Fax:207-942-3325
Practice Address - Street 1:363 MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4210
Practice Address - Country:US
Practice Address - Phone:207-947-4928
Practice Address - Fax:207-942-3325
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEP.S.160103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical