Individual
ERIN MARIE CARROLL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
288 GALLISON HILL RD, MONTPELIER, VT 05602-8352
(802) 793-8307
Mailing address
PO BOX 75, ROXBURY, VT 05669-0075
(802) 595-2957
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1062774
VT
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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