Individual
ELI BURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
47 WILLISTON ST, BRATTLEBORO, VT 05301-5939
(802) 257-4880
Mailing address
PO BOX 915, BRATTLEBORO, VT 05302-0915
(802) 257-4880
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0046268
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016622
—
VT
Enumeration date
06/16/2009
Last updated
01/19/2012
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