Individual
MS. KIMBERLY D AUSTIN PULEIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW LADC
Contact information
Practice address
111 MAIN ST, HYDE PARK, VT 05655
(802) 888-6215
Mailing address
101 COMMONWEALTH AVE, HYDE PARK, VT 05655-9411
(802) 888-3314
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000367
VT
1041C0700X
Clinical Social Worker
Primary
089-0001092
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012955
—
VT
Enumeration date
01/03/2007
Last updated
06/12/2009
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