Individual
ANDREA WILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4756 ROUTE 5, PASSUMPSIC, VT 05861
(636) 255-4374
Mailing address
PO BOX 86, PASSUMPSIC, VT 05861-0086
(636) 255-4374
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890001036
VT
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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