Individual
SUZANNE MARIE POTENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4324
Mailing address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4324
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000850
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0890000850
STATE LICENSE
VT
Enumeration date
12/05/2007
Last updated
12/06/2007
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