Healthcare Provider Details

I. General information

NPI: 1821669805
Provider Name (Legal Business Name): NEW ENGLAND FORENSIC ASSESSMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 HEGEMAN AVE STE 104
COLCHESTER VT
05446-3109
US

IV. Provider business mailing address

91 CAPTAIN CARLTONS RD
COTUIT MA
02635-2706
US

V. Phone/Fax

Practice location:
  • Phone: 802-876-7613
  • Fax: 802-876-7813
Mailing address:
  • Phone: 802-391-7125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ROBERT MARTIN DUWORS
Title or Position: DIRECTOR
Credential: PH.D
Phone: 802-876-7613