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General NPI Number Information
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NPI Number | 1568184992
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Entity Type | Organization
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Legal Business Name | TAMARACK INTEGRATIVE PSYCHIATRY PLLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 928 FALL RD SUITE 1
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City | SHELBURNE
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State | VT
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Zip | 05482
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Country | US
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Telephone | 802-404-5140
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Fax |
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Provider Business Mailing Address
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Address Line | 5 TAMARACK RD
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City | CHARLOTTE
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State | VT
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Zip | 05445-9629
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Country | US
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Telephone | 413-212-4143
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SUZAN RIGGSBEE WHITE
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Credential | DO
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Telephone | 802-404-5140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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