Individual
MR. LAURANCE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
130 FISHER RD STE 1-6, BERLIN, VT 05602-9000
(802) 272-5919
(802) 223-7444
Mailing address
2559 EAGLE PEAK RD, WEST BROOKFIELD, VT 05060-9794
(802) 272-5919
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
047-00062
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010122
—
VT
Enumeration date
08/31/2006
Last updated
07/08/2007
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