Individual
MS. ANDREA WALDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCMHC
Contact information
Practice address
5138 SHELBURNE RD, SHELBURNE, VT 05482-6698
(802) 363-9515
Mailing address
PO BOX 846, SHELBURNE, VT 05482-0846
(802) 363-9515
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000331
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006797
—
VT
Enumeration date
12/18/2006
Last updated
07/09/2007
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