Provider Demographics
NPI:1043494669
Name:SMITH, RONALD J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 HANLEY LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-3146
Mailing Address - Country:US
Mailing Address - Phone:802-899-1025
Mailing Address - Fax:
Practice Address - Street 1:8 ESSEX WAY
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:VT
Practice Address - Zip Code:05451-8268
Practice Address - Country:US
Practice Address - Phone:802-288-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT891103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist