Doctor Name: | THOMAS HERSH |
NPI Number: | 1952338097 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | VT642 |
Business Practice Address: | 83 Radway Hill Rd. Newfane, VT - 05345 |
Business Phone Number: | 8023659245 |
Business Fax Number: | 8023659333 |
Mailing Address: | Po Box 370, NEWFANE |
State: | VT |
Postal Code: | 053450370 |
Phone Number: | 8023659245 |
Fax Number: | 8023659333 |
NPI Enumeration Date: | 06/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | VT642 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |