Individual
MS. ALICIA MARIE WUESTHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
5 COURT ST, RUTLAND, VT 05701-4034
(802) 775-5190
Mailing address
5 COURT ST, RUTLAND, VT 05701-4034
(802) 775-5190
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000075
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00029288
BCBS PF VT
VT
Enumeration date
03/27/2007
Last updated
07/08/2007
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