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Individual

AMANDA CUSHING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
26 CEDAR LANE, DANVILLE, VT 05828
(802) 684-2275
Mailing address
4503 DUCK POND RD, WATERFORD, VT 05819-4530

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890071950
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1019321
VT
Enumeration date
11/30/2010
Last updated
09/29/2011
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