Individual
MS. MARY JANE EGERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
506 TRIPP LANE, ST JOHNSBURG, VT 05819
(802) 748-9510
Mailing address
506 TRIPP LANE, ST JOHNSBURY, VT 05819
(802) 748-9510
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
291
NH
1041C0700X
Clinical Social Worker
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006098
—
VT
Enumeration date
11/09/2007
Last updated
11/09/2007
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