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Individual

DR. EDWARD GEORGE XIPPOLITOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
7205 MAIN ST, SUITE #3, MANCHESTER CENTER, VT 05255-9312
(802) 366-9122
Mailing address
PO BOX 987, MANCHESTER CENTER, VT 05255-0987
(802) 366-9122

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
002612
CT
103TC0700X
Clinical Psychologist
Primary
0859
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011379
VT
Enumeration date
10/03/2006
Last updated
07/08/2007
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