Provider Demographics
NPI:1821245713
Name:WORKMAN-DANIELS, KATHRYN (PHD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WORKMAN-DANIELS
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 1:108 CHERRY ST
Mailing Address - Street 2:CSHN P.O. BOX 70
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4295
Mailing Address - Country:US
Mailing Address - Phone:802-863-7338
Mailing Address - Fax:
Practice Address - Street 1:108 CHERRY ST
Practice Address - Street 2:CSHN
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4295
Practice Address - Country:US
Practice Address - Phone:802-863-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000922103G00000X
NH1167103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist