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General NPI Number Information
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NPI Number | 1043375249
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Entity Type | Individual
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Provider Name | SETH BROWNSTEIN LIC PSYCH-MASTER
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 12/01/2017
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Provider Practice Location Address
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Address Line | 431 PINE ST SUITE 201
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City | BURLINGTON
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State | VT
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Zip | 05401-4726
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Country | US
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Telephone | 802-865-9886
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Fax | 802-865-3737
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Provider Business Mailing Address
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Address Line | 431 PINE ST STE 202
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City | BURLINGTON
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State | VT
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Zip | 05401-4726
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Country | US
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Telephone | 802-865-9886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 047-0000367
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License Number State | VT
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