Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 042-0005584 | VT |
NPI | 1194712034 |
---|---|
Provider Name | Timothy Rowland |
First Address | Brattleboro, VT 05302-0101 |
Second Address | Brattleboro, VT 05301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 03/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000659 | (05) | VT |
C65452 | (02) |