Healthcare Provider Details

I. General information

NPI: 1417720244
Provider Name (Legal Business Name): ROBERT M DUWORS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 HEGEMAN AVE STE 106
COLCHESTER VT
05446-3109
US

IV. Provider business mailing address

162 HEGEMAN AVE STE 106
COLCHESTER VT
05446-3109
US

V. Phone/Fax

Practice location:
  • Phone: 802-876-7613
  • Fax: 802-876-7813
Mailing address:
  • Phone: 802-876-7613
  • Fax: 802-876-7813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. SAM SNYDER
Title or Position: OFFICE/PSYCHOMETRIST
Credential:
Phone: 802-876-7613