Individual
THERESA CHANCE GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2076 EAST ST, BRIDPORT, VT 05734-9680
(802) 758-2476
Mailing address
2076 EAST ST, BRIDPORT, VT 05734-9680
(802) 758-2476
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000196
VT
Other
Enumeration date
01/22/2008
Last updated
01/22/2008
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