Individual
LAURA KELLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
ANNA MARSH LANE, BRATTLEBORO, VT 05301
(802) 257-7785
(802) 258-3798
Mailing address
P.O. BOX 101, ANNA MARSH LANE, BRATTLEBORO, VT 05302-0101
(802) 257-7785
(802) 258-3798
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000805
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009256
—
VT
Enumeration date
07/23/2007
Last updated
07/23/2007
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