Provider Demographics
NPI:1134132053
Name:HEMMER, ROBERT CHARLES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHARLES
Last Name:HEMMER
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 1:157 COBBLE HL
Mailing Address - Street 2:
Mailing Address - City:SHAFTSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05262-9241
Mailing Address - Country:US
Mailing Address - Phone:802-362-5660
Mailing Address - Fax:802-447-3392
Practice Address - Street 1:5271 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-9776
Practice Address - Country:US
Practice Address - Phone:802-362-5660
Practice Address - Fax:802-447-3392
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT687103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1512Medicare UPIN