Provider Demographics
NPI:1508193814
Name:RICKARD, KATHRYN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:M
Last Name:RICKARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-2905
Mailing Address - Country:US
Mailing Address - Phone:802-223-6562
Mailing Address - Fax:
Practice Address - Street 1:141 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2905
Practice Address - Country:US
Practice Address - Phone:802-223-6562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist