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General NPI Number Information
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NPI Number | 1447129754
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Entity Type | Individual
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Provider Name | SHAHRZAD AHMADKARAJI
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Gender | Female
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 2 COLCHESTER AVE VERMONT PSYCHOLOGICAL SERVICES
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City | BURLINGTON
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State | VT
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Zip | 05405-0001
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Country | US
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Telephone | 802-656-2661
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Fax |
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Provider Business Mailing Address
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Address Line | 224 MARKET ST UNIT 210
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-4612
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Country | US
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Telephone |
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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 | 097.0136562
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License Number State | VT
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