Individual
MS. SALLY LOUISE MATTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
72 GROVE ST, BRATTLEBORO, VT 05301-6040
(802) 257-4555
Mailing address
72 GROVE ST, BRATTLEBORO, VT 05301-6040
(802) 257-4555
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
294
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635
BLUE CROSS BLUE SHIELD
VT
01
—
294
LICENSE #
VT
Enumeration date
10/01/2006
Last updated
07/08/2007
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