Individual
EDNA LOUISE LACLAIR-PETIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1180 LANE RD, NEWPORT, VT 05855-8754
(802) 673-6814
Mailing address
1180 LANE RD, NEWPORT, VT 05855-8754
(802) 673-6814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000617
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007686
—
VT
Enumeration date
11/25/2006
Last updated
02/09/2011
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