Individual
JACQUELYN ELLEN BODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
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
101YA0400X
Addiction (Substance Use Disorder) Counselor
291
VT
103T00000X
Psychologist
Primary
269
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002611
—
VT
Enumeration date
09/20/2006
Last updated
09/11/2025
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