Organization
TAGE LILJA LICSW PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAGE LILJA LICSW (OWNER)
(802) 391-9865
Entity
Organization
Contact information
Practice address
125 SAINT PAUL ST STE 107, BURLINGTON, VT 05401-8462
(802) 391-9865
Mailing address
391 SOUTHWIND RD, HINESBURG, VT 05461-4448
(802) 391-9865
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
07/30/2019
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