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General NPI Number Information
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NPI Number | 1962199638
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Entity Type | Organization
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Legal Business Name | MARC A. CECIL, PH.D., P.C.
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 65 N MAIN ST
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City | RUTLAND
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State | VT
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Zip | 05701-3252
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Country | US
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Telephone | 802-773-3616
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Fax |
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Provider Business Mailing Address
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Address Line | 65 N MAIN ST
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City | RUTLAND
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State | VT
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Zip | 05701-3252
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Country | US
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Telephone | 802-773-3616
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND OWNER
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Name | MARC A CECIL A CECIL
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Credential | PH.D.
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Telephone | 802-773-3616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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