Individual
MR. GLENN MITCHELL CRATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
341 VT RT 315, RUPERT, VT 05768-0029
(802) 287-1515
Mailing address
PO BOX 29, 341 VT RT 315, RUPERT, VT 05768-0029
(802) 394-7814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000286
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00059411
BCBS
VT
05
—
1006793
—
VT
Enumeration date
12/21/2006
Last updated
04/25/2023
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