Individual
DANIELLE JATLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW,LADC
Contact information
Practice address
1025 AIRPORT DR, SOUTH BURLINGTON, VT 05403-6013
(802) 488-7711
Mailing address
208 FLYNN AVE, SUITE 3J, BURLINGTON, VT 05401-5429
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151-0126413
VT
1041C0700X
Clinical Social Worker
Primary
089-0066071
VT
Other
Enumeration date
02/06/2013
Last updated
08/20/2019
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