Provider Demographics
NPI:1881765345
Name:SANBORN, DONALD EDWARD III (PSY D)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:EDWARD
Last Name:SANBORN
Suffix:III
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:BELLOWS FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101
Mailing Address - Country:US
Mailing Address - Phone:802-463-3481
Mailing Address - Fax:
Practice Address - Street 1:40 ATKINSON ST
Practice Address - Street 2:
Practice Address - City:BELLOWS FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101-1521
Practice Address - Country:US
Practice Address - Phone:802-463-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0470000163103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006518Medicaid
VT6518OtherALL OTHER INSURANCES
VT0006518Medicaid