Organization
STATE STREET TMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADA MARIE KHOSLA MD (OWNER)
(903) 213-1005
Entity
Organization
Contact information
Practice address
147 STATE ST, MONTPELIER, VT 05602-3301
(802) 321-3692
Mailing address
147 STATE ST, MONTPELIER, VT 05602-3301
(802) 321-3692
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/08/2023
Last updated
02/19/2025
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