Organization
EJD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA NICOLE DEMARTINO (PSYCHOTHERAPIST)
(802) 730-2950
Entity
Organization
Contact information
Practice address
33 BUSHEY RD, MIDDLESEX, VT 05602-9200
(802) 730-2950
Mailing address
136 N MAIN ST STE 1, BARRE, VT 05641-4118
(802) 730-2950
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/10/2016
Last updated
03/10/2016
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