Individual
KELLY J GIANCOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
3 WOODLAND DR, RUTLAND, VT 05701-4629
(802) 236-0358
Mailing address
3 WOODLAND DR, RUTLAND, VT 05701-4629
(802) 236-0358
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0134406
VT
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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