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Individual

MS. JOAN L. FISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NPP

Contact information

Practice address
160 BENMONT AVE, SUITE 20, BENNINGTON, VT 05201-1873
(802) 442-3520
(802) 447-3392
Mailing address
160 BENMONT AVE, SUITE 20, BENNINGTON, VT 05201-1873
(802) 442-3520
(802) 447-3392

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1010021334
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1012012
VT
Enumeration date
11/03/2006
Last updated
08/13/2010
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