Healthcare Provider Details

I. General information

NPI: 1073444907
Provider Name (Legal Business Name): REBECCA LAUREN BUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ANNA MARSH LN
DUMMERSTON VT
05301-3292
US

IV. Provider business mailing address

22 ANNA MARSH LN
DUMMERSTON VT
05301-3292
US

V. Phone/Fax

Practice location:
  • Phone: 802-358-3737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: