Individual
MS. MARY JEAN WOODBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LADC, CSAT-S
Contact information
Practice address
14 PARK PL, SUITE # 3, BRATTLEBORO, VT 05301-2821
(802) 380-3994
Mailing address
1361 POND RD, VERNON, VT 05354-9624
(802) 380-3994
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000267
VT
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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