Individual
BRUCE A BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.W.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000306
VT
1041C0700X
Clinical Social Worker
Primary
089-0000555
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN 1840
—
VT
Enumeration date
05/21/2007
Last updated
05/10/2010
Update your record
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