Individual
THOMAS VAUTRINOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
20 TREMONT ST, SUITE 31, DUXBURY, MA 02332-5310
(617) 633-7041
Mailing address
20 TREMONT ST, SUITE 31, DUXBURY, MA 02332-5310
(617) 633-7041
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
8510
MA
103TC0700X
Clinical Psychologist
Primary
8510
MA
103TC2200X
Clinical Child & Adolescent Psychologist
8510
MA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
8510
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M18467
BLUE CROSS/BLUE SHIELD OF MASSACHUSETTS
MA
Enumeration date
07/13/2006
Last updated
07/28/2010
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