Healthcare Provider Details

I. General information

NPI: 1326139908
Provider Name (Legal Business Name): NANCY M. HODGKINS PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KENNEDY DR SUITE U-8
SOUTH BURLINGTON VT
05403-7152
US

IV. Provider business mailing address

1 KENNEDY DR SUITE U-8
SOUTH BURLINGTON VT
05403-7152
US

V. Phone/Fax

Practice location:
  • Phone: 802-862-0880
  • Fax:
Mailing address:
  • Phone: 802-862-0880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 804
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: