Organization
JACQUELYN E. BODE, M.ED., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELYN ELLEN BODE M.ED. (PRESIDENT)
(802) 747-3488
Entity
Organization
Contact information
Practice address
73 CENTER ST, RUTLAND, VT 05701-4046
(802) 747-3488
(802) 747-0006
Mailing address
73 CENTER ST, RUTLAND, VT 05701-4046
(802) 747-3488
(802) 747-0006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
047.0000269
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002611
—
VT
Enumeration date
09/15/2010
Last updated
09/15/2010
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