Basic Information
| Provider Information | |||||||||
| NPI: | 1578894572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RANGER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 86 LAKE ST | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028653450 | ||||||||
| FaxNumber: | 8028605011 | ||||||||
| Practice Location | |||||||||
| Address1: | 86 LAKE ST | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028653450 | ||||||||
| FaxNumber: | 8028605011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2010 | ||||||||
| LastUpdateDate: | 01/15/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 100-0057170 | VT | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.