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Individual

DR. ALEXANDRA C GERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
144 SOUTH MAIN STREET, HARDWICK, VT 05843
(802) 472-3151
Mailing address
PO BOX 297, HARDWICK, VT 05843-0297
(802) 472-3151

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000083
VT
101YM0800X
Mental Health Counselor
068-0000636
VT
103TC0700X
Clinical Psychologist
Primary
048-0000907
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00068856
BCBS PROVIDER ID #
VT
05
1010328
VT
Enumeration date
12/05/2006
Last updated
08/29/2007
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