Individual
TANYA REXFORD SEARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
194 MAIN ST, SUITE 210, NEWPORT, VT 05855-6104
(802) 334-6280
Mailing address
194 MAIN ST, SUITE 210, NEWPORT, VT 05855-6104
(802) 334-6280
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
703
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008666
—
VT
01
—
58683
BLUE CROSS & BLUE SHIELD
VT
01
—
890098
MVP
VT
Enumeration date
05/24/2007
Last updated
07/08/2007
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