Individual
MR. CHARLES DAVID GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
149 CHERRY ST, BURLINGTON, VT 05401-3817
(802) 863-2495
(802) 865-0534
Mailing address
473 NORTH ST, BURLINGTON, VT 05401-1620
(802) 863-2325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000030
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006770
—
VT
Enumeration date
11/13/2006
Last updated
01/29/2008
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