Individual
JULIE BASCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 OLD ETNA RD, LEBANON, NH 03766-1937
(603) 443-9875
Mailing address
47 VT ROUTE 14 N, EAST RANDOLPH, VT 05041-9523
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8021582
VT
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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