| Mary Jean Sadlak Phd Pc | |
|
160 Benmont Ave Suite 20 Bennington VT 05201-1873 | |
| (802) 442-3520 | |
| (802) 447-3392 |
| Full Name | Mary Jean Sadlak Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 160 Benmont Ave, Bennington, Vermont |
| Authorized Official Name and Position | Mary Jean Sadlak (OWNER) |
| Authorized Official Contact | 8024423520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Jean Sadlak Phd Pc 160 Benmont Ave Suite 20 Bennington VT 05201-1873 Ph: (802) 442-3520 | Mary Jean Sadlak Phd Pc 160 Benmont Ave Suite 20 Bennington VT 05201-1873 Ph: (802) 442-3520 |
| NPI Number | 1013301324 |
|---|---|
| Provider Enumeration Date | 03/25/2015 |
| Last Update Date | 12/23/2015 |
| Medicare PECOS PAC ID | 1759686769 |
|---|---|
| Medicare Enrollment ID | O20160229001017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013301324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 048.0000505 (Vermont) | Primary |
| Provider Name | Mary Jean Sadlak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659435147 PECOS PAC ID: 0840207585 Enrollment ID: I20060321000373 |
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