Peter Lebenbaum
Psychologist in Middlebury, VT. Individual provider (NPI-1).
NPI number1083833859
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1083833859
- Entity type
- Individual (NPI-1)
- Name
- Peter Lebenbaum
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 24, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 048-0000235 | VT | Yes |
Practice location
701 Munger StMiddlebury, VT 05753-8921
Phone 802-388-7830
Mailing address
701 Munger StMiddlebury, VT 05753-8921
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