Individual
JEFFERY M NOWLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADAC
Contact information
Practice address
31 ELMWOOD AVE, BURLINGTON, VT 05401-4347
(802) 864-7423
(802) 660-0576
Mailing address
31 ELMWOOD AVE, BURLINGTON, VT 05401-4347
(802) 864-7423
(802) 660-0576
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104278
VT
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12165201
CAQH
VT
Enumeration date
11/04/2010
Last updated
11/04/2010
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