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Individual

MS. KAREN EDANA CHALOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
4056 POMFRET ROAD, SOUTH POMFRET, VT 05067-0109
(802) 457-6191
(802) 457-6191
Mailing address
PO BOX 109, 4056 POMFRET ROAD, SOUTH POMFRET, VT 05067-0109
(802) 457-6191
(802) 457-6191

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000996
VT
1041C0700X
Clinical Social Worker
12794
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011535
VT
Enumeration date
01/03/2007
Last updated
09/05/2013
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