Organization
MARY ANN DATTILO BOYD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ANN DATTILO BOYD LICSW (PRESIDENT)
(802) 349-6182
Entity
Organization
Contact information
Practice address
135 S PLEASANT ST, MIDDLEBURY, VT 05753-4456
(802) 349-6182
Mailing address
135 S PLEASANT ST, MIDDLEBURY, VT 05753-4456
(802) 349-6182
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890001058
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011288
—
VT
Enumeration date
10/27/2007
Last updated
01/05/2011
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