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General NPI Number Information
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NPI Number | 1083867287
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Entity Type | Organization
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Legal Business Name | PAUL FOXMAN, PH.D., INC.
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 112 LAKE ST
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City | BURLINGTON
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State | VT
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Zip | 05401-5284
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Country | US
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Telephone | 802-865-3450
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Fax | 802-859-3309
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Provider Business Mailing Address
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Address Line | 86 LAKE ST
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City | BURLINGTON
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State | VT
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Zip | 05401-5284
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Country | US
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Telephone | 802-865-3450
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Fax | 802-859-3309
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL FOXMAN
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Credential | PH.D.
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Telephone | 802-865-3450
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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 | 0480000185
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License Number State | VT
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