Individual
KELLY SHANNON THORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
11 KNOLL CIR, SOUTH BURLINGTON, VT 05403-7639
(802) 734-1388
Mailing address
11 KNOLL CIR, SOUTH BURLINGTON, VT 05403-7639
(802) 734-1388
Taxonomy
Speciality
Code
Description
License number
State
103TE1100X
Exercise & Sports Psychologist
Primary
048.0000847
VT
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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