Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 4233 | MA |
N | 103TC1900X | Counseling Psychologist | 4233 | MA |
NPI | 1124356233 |
---|---|
Provider Name | Dr. James A Vermilyea |
First Address | Woburn, MA 01801-1883 |
Second Address | Woburn, MA 01801-1883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2009 |
Last Update Date | 27/04/2012 |