Individual
MRS. LYDIA GOODWIN PENNOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
328 URIE RD, CRAFTSBURY COMMON, VT 05827-9756
(802) 755-6780
Mailing address
328 URIE RD, CRAFTSBURY COMMON, VT 05827-9756
(802) 755-6780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0051665
VT
Other
Enumeration date
10/16/2017
Last updated
11/07/2017
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