Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 0680000632 | VT |
NPI | 1164746459 |
---|---|
Provider Name | Tammie Lowell |
First Address | Morrisville, VT 05661-0749 |
Second Address | Morrisville, VT 05661-5900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2010 |
Last Update Date | 01/06/2012 |