Provider Demographics
NPI:1679745707
Name:D'AMICO, DANIELLE ROBILLARD (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ROBILLARD
Last Name:D'AMICO
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 1:111 COLCHESTER AVE
Mailing Address - Street 2:FAHC - PSYCHOLOGICAL SERVICES, PATRICK 4
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-4923
Mailing Address - Fax:802-847-8961
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:FAHC - PSYCHOLOGICAL SERVICES, PATRICK 4
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-4923
Practice Address - Fax:802-847-8961
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000919103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist