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Individual

DR. DOUGLAS MARR SPECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
540 ROUTE 5 SOUTH, BRADFORD, VT 05033
(802) 222-9001
(802) 222-9242
Mailing address
PO BOX 88, BRADFORD, VT 05033
(802) 222-9001
(802) 222-9242

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
754
VT
103TC0700X
Clinical Psychologist
918
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007089
VT
05
30423048
NH
Enumeration date
03/28/2007
Last updated
07/08/2007
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