Individual
KENNETH C THUNBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH D
Contact information
Practice address
70 S WINOOSKI AVE, SUITE 288, BURLINGTON, VT 05401-3898
(802) 651-9700
(210) 615-2279
Mailing address
7272 WURZBACH RD, SUITE 601, SAN ANTONIO, TX 78240-4801
(210) 615-8880
(210) 615-2279
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
048-0000875
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN3913
—
VT
Enumeration date
08/08/2006
Last updated
02/26/2008
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