Provider Demographics
NPI:1164816310
Name:ERIN ROLAND, PH.D., PLC
Entity Type:Organization
Organization Name:ERIN ROLAND, PH.D., PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:BREE
Authorized Official - Last Name:ROLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:802-540-8140
Mailing Address - Street 1:3 MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5216
Mailing Address - Country:US
Mailing Address - Phone:802-540-8140
Mailing Address - Fax:802-318-4391
Practice Address - Street 1:3 MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-5216
Practice Address - Country:US
Practice Address - Phone:802-540-8140
Practice Address - Fax:802-318-4391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0480060637261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health