Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 048-0000896 | VT |
N | 103T00000X | Psychologist | 048-0000896 | VT |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 048-0000896 | VT |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 048-0000896 | VT |
Y | 103G00000X | Clinical Psychologist | 048-0000896 | VT |
Y | 103TC0700X | Clinical Psychologist | 048-0000896 | VT |
N | 103TC1900X | Counseling Psychologist | 048-0000896 | VT |
NPI | 1104981364 |
---|---|
Provider Name | Dean E Hammer |
First Address | Bennington, VT 05201-2273 |
Second Address | Bennington, VT 05201-2273 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 02/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013953 | (05) | VT |
2340554 | CIGNA (01) | VT |
69789 | BLUE CROSS (01) | VT |