Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 687 | VT |
NPI | 1134132053 |
---|---|
Provider Name | Dr. Robert Charles Hemmer |
First Address | Shaftsbury, VT 05262-9241 |
Second Address | Manchester Center, VT 05255-9776 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 01/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OVN1512 | (02) | VT |