Individual
PHILIP K BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
139 MAIN ST, SUITE 706D, BRATTLEBORO, VT 05301
(802) 257-4561
Mailing address
139 MAIN ST, SUITE 706D, BRATTLEBORO, VT 05301
(802) 257-4561
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000648
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011176
—
VT
Enumeration date
04/06/2007
Last updated
07/08/2007
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