Individual
KELLY JO WOODSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRC
Contact information
Practice address
2122 LOWER PLN, BRADFORD, VT 05033-8936
(802) 222-8028
Mailing address
2122 LOWER PLN, BRADFORD, VT 05033-8936
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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