Individual
KERRY MCCRACKEN DUCOLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000907
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010387
—
VT
Enumeration date
01/02/2007
Last updated
03/25/2011
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