Bruce, Raven
Bruce, Raven is an individual health care provider with primary practice located at 27 Feral Mtn Rd , Middlesex VT 05602-6700. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bruce, Raven can be contacted via phone (802) 793-9316.Contact Information
Primary practice address
27 Feral Mtn Rd
Middlesex VT 05602-6700
Phone: (802) 793-9316
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 694 | Vermont |
Profile Details
| NPI number | 1841419702 |
|---|---|
| LBN Legal business name | Bruce, Raven |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2007 |
| Last updated | Sep 2nd, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841419702 | NPPES |
| Vermont | MEDICAID | OVN1698 |
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