Doctor Name: | THOMAS EHRENBERG |
NPI Number: | 1174652085 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCMHC |
License Number: | 118 |
Business Practice Address: | 67 Main St # 14 Brattleboro, VT - 053013908 |
Business Phone Number: | 8022577827 |
Business Fax Number: | |
Mailing Address: | 67 Main St, # 14 BRATTLEBORO |
State: | VT |
Postal Code: | 053013908 |
Phone Number: | 8022577827 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 118 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |