Individual
ROBERT DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED
Contact information
Practice address
11 N MAIN ST, RANDOLPH, VT 05060-1126
(802) 728-4466
(802) 728-4197
Mailing address
190 SUGAR PLUM CT, RANDOLPH, VT 05060-9379
(802) 728-6459
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000714
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2393212
CIGNA
VT
Enumeration date
08/01/2007
Last updated
08/01/2007
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