Individual
JUDITH A. DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
167 MAIN ST, SUITE 401, BRATTLEBORO, VT 05301-7128
(802) 257-1660
Mailing address
167 MAIN ST, SUITE 401, BRATTLEBORO, VT 05301-7128
(802) 257-1660
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
206
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006569
—
VT
01
—
062-6569
BLUE CROSS/BLUE SHIELD
VT
01
—
410046
MVP PROVIDER NUMBER
VT
Enumeration date
10/10/2006
Last updated
07/08/2007
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