Doctor Name: | MS. BETH ANNE WERMUTH |
NPI Number: | 1710099791 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 047-0000639 |
Business Practice Address: | 145 Pine Haven Shores Rd Suite 2032 Shelburne, VT - 054827703 |
Business Phone Number: | 8028644513 |
Business Fax Number: | |
Mailing Address: | 417 Pettingill Rd, ESSEX JUNCTION |
State: | VT |
Postal Code: | 054522669 |
Phone Number: | 8028644513 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 047-0000639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |