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South Burlington, Vermont

Provider NPI: 1326372673

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 802-654-7607  Fax: 802-654-9155

Business Mailing Address:
Tel: 802-654-7607  Fax: 802-654-9155

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
N101YS0200XBehavioral Health & Social Service Providers
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
N1041C0700XBehavioral Health & Social Service Providers
Social Worker

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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