Organization
IDLEWILD ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANN CITARELLA MS (CO-OWNER)
(802) 287-0841
Entity
Organization
Contact information
Practice address
153 MAIN ST, POULTNEY, VT 05764-4413
(802) 287-0841
Mailing address
PO BOX 7, POULTNEY, VT 05764-0007
(802) 287-0841
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
097.0107404
VT
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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