Doctor Name: | MR. DAVID MAXWELL DOOLITTLE |
NPI Number: | 1346335346 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED. |
License Number: | 068-0000156 |
Business Practice Address: | 226 Leonard Rd South Royalton, VT - 050689565 |
Business Phone Number: | 8027638773 |
Business Fax Number: | 8027632182 |
Mailing Address: | 226 Leonard Rd, SOUTH ROYALTON |
State: | VT |
Postal Code: | 050689565 |
Phone Number: | 8027638773 |
Fax Number: | 8027632182 |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 068-0000156 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |