Individual
MRS. EILEEN MARIE REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2 S MAIN ST STE3, RUTLAND, VT 05701-4136
(802) 773-3533
(802) 773-3533
Mailing address
2 S MAIN ST, SUITE 3, RUTLAND, VT 05701-4161
(802) 773-3533
(802) 773-3533
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000505
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00069614
BLUE CROSS BLUE SHIELD OF
VT
05
—
1012957
—
VT
01
—
4151133
MVP HEALTH CARE
VT
Enumeration date
12/01/2006
Last updated
11/06/2015
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