Individual
MS. TISHA MESA SHULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
262 NORTH AVE, BURLINGTON, VT 05401-2916
(802) 373-3472
Mailing address
262 NORTH AVENUE, BURLINGTON, VT 05401
(802) 373-3472
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0090925
VT
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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