Individual
JULIA MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
239 S UNION ST, BURLINGTON, VT 05401-4886
(802) 343-7574
Mailing address
91B WEST ST, WINOOSKI, VT 05404-1926
(802) 343-7574
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
164.0000286
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.0000286
MASSAGE THERAPIST, BODYWORKER, OR TOUCH PROFESSIONAL LICENSE
VT
Enumeration date
03/19/2021
Last updated
03/19/2021
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