Individual
AMANDA LYNN LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 TALCOTT RD STE 114, WILLISTON, VT 05495-2094
(802) 235-9322
Mailing address
272 E BAKERSFIELD RD, BAKERSFIELD, VT 05441-9725
(802) 782-5460
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31867
VT
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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