Healthcare Provider Details

I. General information

NPI: 1619198397
Provider Name (Legal Business Name): BREE GREENBERG-BENJAMIN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PATCHEN RD
SOUTH BURLINGTON VT
05403-5704
US

IV. Provider business mailing address

770 HARVEY FARM RD
WATERBURY CENTER VT
05677-7127
US

V. Phone/Fax

Practice location:
  • Phone: 802-658-4208
  • Fax:
Mailing address:
  • Phone: 802-244-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number100-0000051
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: