Individual
MR. JESSE MICHAEL TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
112 LAKE ST STE 210, BURLINGTON, VT 05401-5284
(802) 865-3450
Mailing address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0135591
VT
Other
Enumeration date
04/04/2023
Last updated
11/03/2023
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