Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 048-0000917 | VT |
Y | 103TC0700X | Clinical Psychologist | 048-0000917 | VT |
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities |
NPI | 1073665410 |
---|---|
Provider Name | Dr. Marion E Palermo |
First Address | Essex Junction, VT 05452-2936 |
Second Address | Essex Junction, VT 05452-2936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 16/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1016742 | (05) | VT |