Doctor Name: | MR. THOMAS GEORGE KYLE |
NPI Number: | 1194719229 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA |
License Number: | 47-000553 |
Business Practice Address: | 79 Main St Montpelier, VT - 056023173 |
Business Phone Number: | 8022230162 |
Business Fax Number: | 8022290594 |
Mailing Address: | 79 Main St, MONTPELIER |
State: | VT |
Postal Code: | 056023173 |
Phone Number: | 8022230162 |
Fax Number: | 8024799050 |
NPI Enumeration Date: | 09/05/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 47-000553 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |