Individual
MOLLY SHRIVER-BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
102 SUBURBAN SQ, SOUTH BURLINGTON, VT 05403-6458
(802) 595-9278
(802) 595-9278
Mailing address
102 SUBURBAN SQ, SOUTH BURLINGTON, VT 05403-6458
(802) 595-9278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0100267
VT
1041C0700X
Clinical Social Worker
P006371
NC
Other
Enumeration date
08/05/2011
Last updated
07/21/2022
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