Organization
GREEN MOUNTAIN PSYCHOLOGICAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE RAE BERGERON INGRAM M.S. (CEO)
(802) 353-6580
Entity
Organization
Contact information
Practice address
79 COURT ST, MIDDLEBURY, VT 05753-1406
(802) 353-6580
Mailing address
93 COURT ST # A, MIDDLEBURY, VT 05753-4423
(802) 353-6580
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0470111914
VT
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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