Individual
JACOB EDMONDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
149 STATE ST UNIT 6, MONTPELIER, VT 05602-2965
(802) 522-8298
Mailing address
28 RIDGEWOOD TER, BARRE, VT 05641-9738
(802) 522-9211
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
VT
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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