Individual
JESSICA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
35 KING ST, SUITE 8, BURLINGTON, VT 05401-4880
(802) 363-4311
Mailing address
35 KING ST, SUITE 8, BURLINGTON, VT 05401-4880
(802) 363-4311
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
047.0102268
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023934
—
VT
Enumeration date
09/23/2014
Last updated
01/10/2015
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