Pezzulich, Lisa M

Pezzulich, Lisa M is an individual health care provider with primary practice located at 160 Benmont Ave Suite 20, Bennington VT 05201-1873. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Pezzulich, Lisa M can be contacted via phone (802) 442-3520.

Contact Information

Primary practice address
160 Benmont Ave Suite 20 Bennington VT 05201-1873
Phone: (802) 442-3520
Fax: (802) 447-3392
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 048-0000729 Vermont

Profile Details

NPI number 1417040767
LBN Legal business name Pezzulich, Lisa M
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2006
Last updated Jul 22nd, 2010 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1417040767 NPPES
Vermont MEDICAID OVN1922

Popular Providers