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Individual

THOMAS HERSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
83 RADWAY HILL RD., NEWFANE, VT 05345
(802) 365-9245
(802) 365-9333
Mailing address
PO BOX 370, NEWFANE, VT 05345-0370
(802) 365-9245
(802) 365-9333

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
VT642
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
288908
MAGELLAN
VT
01
29886
BLUE CROSS BLUE SHIELD
VT
05
OVN1668
VT
01
W06267
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/26/2006
Last updated
07/08/2007
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