Individual
MS. JULIE LYNNE BOMENGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
111 MAIN ST, GRANT BUILDING, HYDE PARK, VT 05655
(802) 888-6215
(802) 888-9474
Mailing address
3491 ELMORE MTN RD, MORRISVILLE, VT 05661
(802) 888-9345
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000519
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008302
—
VT
Enumeration date
01/23/2007
Last updated
07/08/2007
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