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Individual

MR. ERIC PETER SMALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MACP

Contact information

Practice address
2 CHURCH STREET, BURLINGTON, VT 05401
(802) 863-1019
Mailing address
8 TOURIN RD, JERICHO, VT 05465
(802) 899-4443

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
397
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1006015
VT
Enumeration date
02/21/2007
Last updated
07/08/2007
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