Individual
CAROL ELISSA OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
28 LAKE MOREY RD APT 2, FAIRLEE, VT 05045-9824
(207) 779-7635
(207) 779-7635
Mailing address
PO BOX 15, THETFORD, VT 05074-0015
(207) 779-7635
(978) 356-2015
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0135072
VT
Other
Enumeration date
10/16/2006
Last updated
03/18/2024
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