Healthcare Provider Details

I. General information

NPI: 1194712034
Provider Name (Legal Business Name): TIMOTHY ROWLAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ANNA MARSH LANE
BRATTLEBORO VT
05301
US

IV. Provider business mailing address

P.O. BOX 101
BRATTLEBORO VT
05302-0101
US

V. Phone/Fax

Practice location:
  • Phone: 802-257-7785
  • Fax:
Mailing address:
  • Phone: 802-257-7785
  • Fax: 802-258-3798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number042-0005584
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: