Doctor Name: | JASON HERBERT FECHTER |
NPI Number: | 1134160310 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | 0470000722 |
Business Practice Address: | 34 Pleasant St Morrisville, VT - 056614434 |
Business Phone Number: | 8028889957 |
Business Fax Number: | 8028889957 |
Mailing Address: | Po Box 485, MORRISVILLE |
State: | VT |
Postal Code: | 056610485 |
Phone Number: | 8028889957 |
Fax Number: | 8028889957 |
NPI Enumeration Date: | 06/09/2006 |
NPI Last Update Date: | 09/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0470000722 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |