Organization
TACONIC INTEGRATIVE PSYCHIATRIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM PRUETT (CO-OWNER)
(802) 774-8358
Entity
Organization
Contact information
Practice address
4384 MAIN STREET, MANCHESTER, VT 05254
(802) 768-9136
Mailing address
365 WEST RD, MANCHESTER CENTER, VT 05255-6308
(802) 774-8358
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/21/2020
Last updated
04/27/2023
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