Provider Demographics
NPI:1124038211
Name:COTTON, NANCY SHEA (PHD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SHEA
Last Name:COTTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 S WILLARD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3901
Mailing Address - Country:US
Mailing Address - Phone:802-860-0162
Mailing Address - Fax:802-860-0164
Practice Address - Street 1:186 S WILLARD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3901
Practice Address - Country:US
Practice Address - Phone:802-860-0162
Practice Address - Fax:802-860-0164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0480000640103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist