| Doctor Name: | ADAM MATTHEW GRUNDT |
| NPI Number: | 1144371972 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | LP4353 |
| Business Practice Address: | 132 South Main Street Hardwick, VT - 05843 |
| Business Phone Number: | 8026837533 |
| Business Fax Number: | 7635590149 |
| Mailing Address: | 18 Loomis Street, #1 MONTPELIER |
| State: | VT |
| Postal Code: | 05602 |
| Phone Number: | 7635093818 |
| Fax Number: | 7635590149 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 05/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP4353 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |