Individual
JOHN PENOYAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1 MILL ST, SUITE 204, BURLINGTON, VT 05401-1530
(802) 860-8435
Mailing address
1041 POND RD, HINESBURG, VT 05461-9196
(802) 860-8435
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
047-0000630
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005771
—
VT
Enumeration date
05/23/2006
Last updated
07/08/2007
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