Individual
MRS. KIMBERLY DENA LIGHTBEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LADC
Contact information
Practice address
108 CHERRY STREET, ST JOHNSBURY, VT 05819
(802) 748-8842
(802) 748-9014
Mailing address
108 CHERRY STREET, ST JOHNSBURY, VT 05819
(802) 748-8842
(802) 748-9014
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000418
VT
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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