Individual
MATTHEW WALLACE EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
107 FISHER POND RD, SAINT ALBANS, VT 05478-6286
(802) 524-6554
(802) 524-6562
Mailing address
107 FISHER POND RD, SAINT ALBANS, VT 05478-6286
(802) 524-6554
(802) 524-6562
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0134168
VT
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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