Individual
MIRIAM FREDA STOLL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2 COLCHETER AVENUE, BURLINGTON, VT 05405-0134
(802) 656-2661
(802) 656-3482
Mailing address
2 COLCHETER AVENUE, BURLINGTON, VT 05405-0134
(802) 656-2661
(802) 656-3482
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0480000807
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009132
—
VT
01
—
59091
BCBS
VT
Enumeration date
05/13/2006
Last updated
07/08/2007
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