Provider Demographics
NPI:1689774820
Name:BUNK, BARBARA S (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:S
Last Name:BUNK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OAK ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2320
Mailing Address - Country:US
Mailing Address - Phone:860-657-8868
Mailing Address - Fax:860-657-8802
Practice Address - Street 1:200 OAK ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2320
Practice Address - Country:US
Practice Address - Phone:860-657-8868
Practice Address - Fax:860-657-8802
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1203103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical