Emily Mazzulla, PH.D.
Individual provider Active NPI Clinical Psychologist · Burlington, VT
NPI 1043689607 · NPPES record last updated Feb 27, 2017
Key facts
- NPI
- 1043689607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 0480112979 (VT)
- Practice address
- 2 Colchester Ave
Burlington, VT 05405-1764 - Phone
- (802) 656-2661
- Fax
- (802) 656-3485
- NPI assigned
- Sep 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0480112979 | VT | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0480112979 | VT | Yes |
Addresses
Primary practice location
2 Colchester Ave
Burlington, VT 05405-1764
Mailing address
2 Colchester Ave
Burlington, VT 05405-1764
Phone (802) 656-2661
Other providers in Burlington, VT
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- Paul J Mayer
- Alan Michael Maynard
- Darren Waldron Maynard
- Vie Mazur
- Francine Mbayu
- John W MC Avoy
- Andrea June McBride
- Kelly Elizabeth McBride
- Alan McCampbell
All providers in Burlington, VT · Clinical Psychologist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.