Individual
MR. STUART MOORE MACCRELLISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
653 QUARRY RD, NEW HAVEN, VT 05472-2028
(802) 989-2295
Mailing address
653 QUARRY RD, NEW HAVEN, VT 05472-2028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0000971
VT
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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