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Individual

DR. THOMAS POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4281 SHELBURNE RD, SHELBURNE, VT 05482-7121
(802) 985-2412
Mailing address
4281 SHELBURNE RD, P.O. BOX 807, SHELBURNE, VT 05482-7121
(802) 985-2412

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
480
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003074
VT
01
POWE062-8367
BLUE CROSS BLUE SHIELD
VT
Enumeration date
04/02/2007
Last updated
03/05/2014
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