Individual
DR. KATE JESSAMYN LONGMAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
048-0000630
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1205
—
VT
01
—
VN1205
MEDICARE PTAN
VT
Enumeration date
02/06/2006
Last updated
10/11/2013
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