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Individual

LAURA G ETHIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
420 GROVE ST, BRANDON, VT 05733-9062
(802) 247-6305
(802) 247-6040
Mailing address
215 STRATTON RD, RUTLAND, VT 05701-4621
(802) 855-2027
(802) 855-2053

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
089.0001266
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021427
VT
Enumeration date
12/03/2012
Last updated
07/15/2015
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