Doctor Name: | MICHAEL HENRY EARLEY |
NPI Number: | 1124290812 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | 068-0000598 |
Business Practice Address: | 44 Fuller Dr Brattleboro, VT - 053016500 |
Business Phone Number: | 8022548294 |
Business Fax Number: | |
Mailing Address: | 44 Fuller Dr, BRATTLEBORO |
State: | VT |
Postal Code: | 053016500 |
Phone Number: | 8022548294 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2008 |
NPI Last Update Date: | 04/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 068-0000598 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |