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Individual

JEAN ETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
18 OLD TERRACE, THE WINDHAM CENTER, BELLOW FALLS, VT 05101
(802) 463-1292
Mailing address
252 RIVER ST, C/O NETWORK MANAGEMENT SERVICES, SPRINGFIELD, VT 05156-2306
(802) 885-5785
(802) 885-2030

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000769
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30420624
NH
05
OVN2603
VT
Enumeration date
07/26/2006
Last updated
07/08/2007
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