Individual
KILLY J. BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1222 PUTNEY RD, BRATTLEBORO, VT 05301-9000
(802) 662-1655
Mailing address
PO BOX 8473, BRATTLEBORO, VT 05304-8473
(802) 246-1221
(802) 662-1655
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0087148
VT
Other
Enumeration date
12/10/2008
Last updated
10/28/2024
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