Individual
JENNIFER C FELLOWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1795 WILLISTON RD STE 330, SOUTH BURLINGTON, VT 05403-6487
(802) 233-7420
Mailing address
291 PILLSBURY LN, WILLISTON, VT 05495-8728
(802) 233-7420
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0001142
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015570
—
VT
Enumeration date
04/08/2008
Last updated
07/10/2023
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