Individual
MR. MICHAEL A. ITALIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
139 MAIN ST, SUITE 704, BRATTLEBORO, VT 05301-3040
(802) 254-5875
Mailing address
139 MAIN ST, SUITE 704, BRATTLEBORO, VT 05301-3040
(802) 254-5875
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
419
VT
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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