Organization
NETWORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRIA LOVEJOY (OFFICE MANAGER)
(802) 863-2495
Entity
Organization
Contact information
Practice address
187 SAINT PAUL ST, BURLINGTON, VT 05401-4689
(802) 863-2495
Mailing address
187 SAINT PAUL ST, BURLINGTON, VT 05401-4689
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000480
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007825
—
VT
Enumeration date
01/12/2007
Last updated
08/22/2020
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