Individual
KATHRYN C. STACKPOLE OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
111 MAIN ST, HYDE PARK, VT 05655
(802) 888-6215
(802) 888-9474
Mailing address
PO BOX 24, LAKE ELMORE, VT 05657-0024
(802) 888-6215
(802) 888-9474
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089000725
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008174
—
VT
01
—
58556
BCBS OF VT
VT
Enumeration date
03/29/2007
Last updated
10/01/2012
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