Individual
MRS. AMY KITTREDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCMHC, LADC
Contact information
Practice address
420 GROVE ST, BRANDON, VT 05733-9062
(802) 247-6304
(802) 247-6040
Mailing address
71 ALLEN ST, SUITE 101, RUTLAND, VT 05701-4570
(800) 468-9118
(802) 772-7973
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000626
VT
101YM0800X
Mental Health Counselor
068.0099058
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024498
—
VT
Enumeration date
02/12/2015
Last updated
11/30/2016
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