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Individual

PATRICIA L MARSHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LADC

Contact information

Practice address
179 MAIN STREET, #4, HYDE PARK, VT 05655
(802) 279-1631
(802) 851-1141
Mailing address
PO BOX 334, 179 MAIN STREET #4, HYDE PARK, VT 05655
(802) 279-1631
(802) 851-1141

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
000499
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000499
VT

Other

Enumeration date
09/08/2010
Last updated
02/03/2012
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