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Individual
MR. MARK CARPENTER MUMFORD
Active
Individual
MR. MARK CARPENTER MUMFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
297
VT
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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