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Organization
GROWING MINDS PC
Active
Organization
GROWING MINDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAVEL MALM (OWNER / DIRECTOR)
(802) 327-0077
Entity
Organization
Contact information
Practice address
124 E MAIN ST STE 2, NEWPORT, VT 05855-5561
(802) 327-0077
Mailing address
PO BOX 622, NEWPORT, VT 05855-0622
(802) 327-0077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000594
VT
Other
Enumeration date
05/25/2017
Last updated
05/18/2021
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