Individual
MALLORY DIANA CHARLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
42 SUSIE WILSON RD UNIT 111, ESSEX JUNCTION, VT 05452-2856
(802) 404-2185
Mailing address
42 SUSIE WILSON RD UNIT 111, ESSEX JUNCTION, VT 05452-2856
(028) 922-7672
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0135917
VT
Other
Enumeration date
06/19/2024
Last updated
08/14/2025
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