Individual
MS. JESSICA M. DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2 SUMMER ST, SUITE 3, RANDOLPH, VT 05060-1173
(802) 735-2275
Mailing address
2 SUMMER STREET, RANDOLPH, VT 05060-7149
(802) 735-2275
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
047-0072459
VT
Other
Enumeration date
06/28/2011
Last updated
05/03/2017
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