Individual
EVELYN M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LCMHC
Contact information
Practice address
145 PINE HAVEN SHORES RD STE 2103, SHELBURNE, VT 05482-7703
(802) 578-0342
Mailing address
PO BOX 136, SHELBURNE, VT 05482-0136
(802) 578-0342
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0680000219
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007117
—
VT
Enumeration date
12/06/2005
Last updated
06/07/2024
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