Individual
DR. RAVEN BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
27 FERAL MTN RD, MIDDLESEX, VT 05602-6700
(802) 793-9316
Mailing address
27 FERAL MTN RD, MIDDLESEX, VT 05602-6700
(802) 793-9316
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
694
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OVN1698
—
VT
Enumeration date
04/25/2007
Last updated
09/02/2016
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