Organization
MATRIX HEALTH SYSTEMS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID FASSLER M.D. (CLINICAL DIRECTOR)
(802) 865-3450
Entity
Organization
Contact information
Practice address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450
(802) 860-5011
Mailing address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450
(802) 860-5011
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02112352
—
NY
05
—
OVN1732
—
VT
Enumeration date
05/25/2006
Last updated
11/21/2014
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