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Individual

ETHAN HAZZARD-WATKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
60 AUSTINE DR, BRATTLEBORO, VT 05301-6798
(802) 451-0934
Mailing address
61 ETHAN HL, BRATTLEBORO, VT 05301-8900
(802) 451-0934

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0135152
VT

Other

Enumeration date
09/09/2019
Last updated
04/11/2023
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