Individual
DARIO J LUSSARDI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
25 COLDBROOK RD, WILMINGTON, VT 05363-9624
(802) 464-5550
(802) 464-3657
Mailing address
25 COLDBROOK RD, WILMINGTON, VT 05363-9624
(802) 464-5550
(802) 464-3657
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
047-0000268
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002609
BLUE CROSS & BLUE SHIELD
VT
05
—
0002609
—
VT
Enumeration date
06/17/2006
Last updated
07/09/2007
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