Individual
MR. SUDHIR SHANTINATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
56 W TWIN OAKS TER, SOUTH BURLINGTON, VT 05403-7106
(802) 847-3333
(802) 847-1424
Mailing address
20 HIGH GROVE CT, BURLINGTON, VT 05401-1644
(802) 864-4698
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000839
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN2614
—
VT
Enumeration date
08/23/2006
Last updated
07/08/2007
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