Individual
JESSICA SCHUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
11 MAIN STREET, RANDOLPH, VT 05060
(802) 728-4466
(802) 728-4197
Mailing address
11 MAIN STREET, RANDOLPH, VT 05060
(802) 728-4466
(802) 728-4197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000735
VT
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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